Radioactive iodine uptake test

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Radioactive iodine uptake test
Thyroid scan.jpg
Thyroid scan with Iodine-123 for evaluation of hyperthyroidism.
Synonyms RAIU test
ICD-9-CM 92.01
OPS-301 code 3-701

The radioactive iodine uptake test is a type of scan used in the diagnosis of thyroid problems, particularly hyperthyroidism. It is entirely different from radioactive iodine therapy (RAI therapy), which uses much higher doses to destroy cancerous cells. The RAIU test is also used as a follow-up to RAI therapy to verify that no thyroid cells survived, which could still be cancerous. [1]

Contents

The patient swallows a radioisotope of iodine in the form of capsule or fluid, and the absorption (uptake) of this radiotracer by the thyroid is studied after 4–6 hours and after 24 hours with the aid of a scintillation counter. The dose is typically 0.15–0.37 MBq (4–10 μCi) of 131I iodide, or 3.7–7.4 MBq (100–200 μCi) of 123I iodide. [2] The RAIU test is a reliable measurement when using a dedicated probe with a reproducibility of 1 percent and a 95%-least-significant-change of 3 percent. [3]

The normal uptake is between 15 and 25 percent, but this may be forced down if, in the meantime, the patient has eaten foods high in iodine, such as dairy products and seafood. [4] Low uptake suggests thyroiditis, high uptake suggests Graves' disease, [5] and unevenness in uptake suggests the presence of a nodule.[ citation needed ]

123I has a shorter half-life than 131I (a half day vs. 8.1 days), so use of 123I exposes the body to less radiation, at the expense of less time to evaluate delayed scan images. [6] Furthermore, 123I emits gamma radiation, while 131I emits gamma and beta radiation. [7]

Contraindications

The test is inappropriate for patients who are pregnant or breastfeeding. [5]

Additional images

Related Research Articles

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Hyperthyroidism is the condition that occurs due to excessive production of thyroid hormones by the thyroid gland. Thyrotoxicosis is the condition that occurs due to excessive thyroid hormone of any cause and therefore includes hyperthyroidism. Some, however, use the terms interchangeably. Signs and symptoms vary between people and may include irritability, muscle weakness, sleeping problems, a fast heartbeat, heat intolerance, diarrhea, enlargement of the thyroid, hand tremor, and weight loss. Symptoms are typically less severe in the elderly and during pregnancy. An uncommon but life-threatening complication is thyroid storm in which an event such as an infection results in worsening symptoms such as confusion and a high temperature; this often results in death. The opposite is hypothyroidism, when the thyroid gland does not make enough thyroid hormone.

Radionuclide therapy uses radioactive substances called radiopharmaceuticals to treat medical conditions, particularly cancer. These are introduced into the body by various means and localise to specific locations, organs or tissues depending on their properties and administration routes. This includes anything from a simple compound such as sodium iodide that locates to the thyroid via trapping the iodide ion, to complex biopharmaceuticals such as recombinant antibodies which are attached to radionuclides and seek out specific antigens on cell surfaces.

<span class="mw-page-title-main">Nuclear medicine</span> Medical specialty

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A radioactive tracer, radiotracer, or radioactive label is a synthetic derivative of a natural compound in which one or more atoms have been replaced by a radionuclide. By virtue of its radioactive decay, it can be used to explore the mechanism of chemical reactions by tracing the path that the radioisotope follows from reactants to products. Radiolabeling or radiotracing is thus the radioactive form of isotopic labeling. In biological contexts, experiments that use radioisotope tracers are sometimes called radioisotope feeding experiments.

<span class="mw-page-title-main">Nuclear fission product</span> Atoms or particles produced by nuclear fission

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<span class="mw-page-title-main">Potassium iodide</span> Ionic compound (KI)

Potassium iodide is a chemical compound, medication, and dietary supplement. It is a medication used for treating hyperthyroidism, in radiation emergencies, and for protecting the thyroid gland when certain types of radiopharmaceuticals are used. It is also used for treating skin sporotrichosis and phycomycosis. It is a supplement used by people with low dietary intake of iodine. It is administered orally.

<span class="mw-page-title-main">Iodine-131</span> Isotope of iodine

Iodine-131 is an important radioisotope of iodine discovered by Glenn Seaborg and John Livingood in 1938 at the University of California, Berkeley. It has a radioactive decay half-life of about eight days. It is associated with nuclear energy, medical diagnostic and treatment procedures, and natural gas production. It also plays a major role as a radioactive isotope present in nuclear fission products, and was a significant contributor to the health hazards from open-air atomic bomb testing in the 1950s, and from the Chernobyl disaster, as well as being a large fraction of the contamination hazard in the first weeks in the Fukushima nuclear crisis. This is because 131I is a major fission product of uranium and plutonium, comprising nearly 3% of the total products of fission. See fission product yield for a comparison with other radioactive fission products. 131I is also a major fission product of uranium-233, produced from thorium.

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Ioflupane (<sup>123</sup>I) Chemical compound

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<span class="mw-page-title-main">Radiopharmaceutical</span> Pharmaceutical drug which emits radiation, used as a diagnostic or therapeutic agent

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Iodine is a chemical element with many uses in medicine, depending on the form. Elemental iodine and iodophors are topical antiseptics. Iodine, in non-elemental form, functions as an essential nutrient in human biology. Organic compounds containing iodine are also useful iodinated contrast agents in X-ray imaging.

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References

  1. ThyCa: Thyroid Cancer Survivors' Association, Inc., Radioactive Iodine (RAI).
  2. Kwee, Sandi A.; Coel, Marc N.; Fitz-Patrick, David (2007). Eary, Janet F.; Brenner, Winfried (eds.). Iodine-131 Radiotherapy for Benign Thyroid Disease. CRC Press. p. 172. ISBN   978-0-8247-2876-2.{{cite book}}: |journal= ignored (help)
  3. Pelletier-Galarneau, Matthieu; Martineau, Patrick; Klein, Ran; Henderson, Matthew; Zuckier, Lionel S. (January 2018). "Reproducibility of radioactive iodine uptake (RAIU) measurements". Journal of Applied Clinical Medical Physics. 19 (1): 239–242. doi:10.1002/acm2.12217. ISSN   1526-9914. PMC   5768031 . PMID   29165912.
  4. M. Sara Rosenthal. The Thyroid Sourcebook. McGraw-Hill, 2008. Page 140.
  5. 1 2 WebMD article on RAIU test.
  6. Ain, Kenneth; Rosenthal, M. Sara (2010-08-19). The Complete Thyroid Book, Second Edition. McGraw-Hill Professional. pp. 57–. ISBN   978-0-07-174348-8 . Retrieved 18 July 2011.
  7. Pilling, Gwen (1999-06-24). Salters higher chemistry. Heinemann. pp. 132–. ISBN   978-0-435-63098-0 . Retrieved 18 July 2011.