Diuretic Augmentation of 131I Uptake in Inoperable Thyroid Cancer

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Abstract
Diuretics, plus a low-iodine diet, were employed in 25 patients with inoperable thyroid cancer to produce acute iodide depletion and thus augment 131I uptake by the tumor tissue. Initially, intravenous mannitol was used, but more recently oral ethacrynic acid has proved simpler, and more suitable for outpatients. Twofold to threefold increases in 24-hour 131I uptake were achieved in 16, lesser increases in three and no increase in six patients. This increased iodine uptake seemed to be independent of, and additional to that attributable to TSH (whether endogenous by virtue of hypothyroidism or combined endogenous and exogenous). Furthermore, iodine taken up by thyroid tumor tissue after diuretic preparation is well retained for at least 96 hours. Consideration of diuretic augmentation of 131I uptake is justified whenever 131I therapy is contemplated for inoperable thyroid cancer.

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