1. What is Radioactive Iodine 131?

Iodine-131 (131I) 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. 

 

2. What is the mechanism in RAI 131?

Iodine-131 can be "seen" by nuclear medicine imaging techniques whenever it is given for therapeutic use, since about 10% of its energy and radiation dose is via gamma radiation. However, since the other 90% of radiation (beta radiation) causes tissue damage without contributing to any ability to see or "image" the isotope, other less-damaging radioisotopes of iodine such as iodine-123 are preferred in situations when only nuclear imaging is required. The isotope I-131 is still occasionally used for purely diagnostic (i.e., imaging) work, due to its low expense compared to other iodine radioisotopes.

 

3. How to prevent RAI 131?

A common treatment method for preventing iodine-131 exposure is by saturating the thyroid with regular, non-radioactive iodine-127, as an iodide or iodate salt. Free elemental iodine should not be used for saturating the thyroid because it is a corrosive oxidant and therefore is toxic to ingest in the necessary quantities. The thyroid will absorb very little of the radioactive iodine-131 after it is saturated with non-radioactive iodide, thereby avoiding the damage caused by radiation from radioiodine.

 

4. What is detail of I-131 for ablation?

Typical therapeutic doses of I-131 are between 2220-7400 megabecquerels (MBq). Because of this high radioactivity and because the exposure of stomach tissue to beta radiation would be high near an undissolved capsule, I-131 is sometimes administered to human patients in a small amount of liquid. Administration of this liquid form is usually by straw which is used to slowly and carefully suck up the liquid from a shielded container. 

 
5. What should be reminded after RAI treatment?

Ablation doses are usually administered on an inpatient basis, and IAEA International Basic Safety Standards recommend that patients are not discharged until the activity falls below 1100 MBq. ICRP advice states that "comforters and carers" of patients undergoing radionuclide therapy should be treated as members of the public for dose constraint purposes and any restrictions on the patient should be designed based on this principle.

1. Patients receiving I-131 radioiodine treatment may be warned not to have sexual intercourse for one month (or shorter, depending on dose given), 

2. Women told not to become pregnant for six months afterwards. "This is because a theoretical risk to a developing fetus exists, even though the amount of radioactivity retained may be small and there is no medical proof of an actual risk from radioiodine treatment. 

6. How the RAI 131 eliminated from my body?

I-131 will be eliminated from the body over the next several weeks after it is given. The majority of I-131 will be eliminated from the human body in 3–5 days, through natural decay, and through excretion in sweat and urine. Smaller amounts will continue to be released over the next several weeks, as the body processes thyroid hormones created with the I-131. For this reason, it is advised to regularly clean toilets, sinks, bed sheets and clothing used by the person who received the treatment.

 
7. Are there any advice after RAI treatment?

Patients may also be advised to wear slippers or socks at all times, and avoid prolonged close contact with others. This minimizes accidental exposure by family members, especially children. Use of a decontaminant specially made for radioactive iodine removal may be advised.

The use of chlorine bleach solutions, or cleaners that contain chlorine bleach for cleanup, are not advised, since radioactive elemental iodine gas may be released. Airborne I-131 may cause a greater risk of second-hand exposure, spreading contamination over a wide area. Patient is advised if possible to stay in a room with a bathroom connected to it to limit unintended exposure to family members.

Many airports now have radiation detectors to detect the smuggling of radioactive materials. Patients should be warned that if they travel by air, they may trigger radiation detectors at airports up to 95 days after their treatment with 131I.