From the Research
Follicular thyroid adenomas have higher radioactive iodine uptake than papillary thyroid carcinomas because they retain more normal thyroid cell function, as evidenced by the most recent and highest quality study available 1. This is due to several key factors, including:
- The preservation of sodium-iodide symporter (NIS) expression and function in follicular adenomas, which allows for efficient iodine concentration 1
- The continued response to thyroid-stimulating hormone (TSH) regulation in follicular adenomas, enabling active iodine transport and concentration similar to normal thyroid tissue 1
- The dedifferentiation of papillary thyroid carcinomas during malignant transformation, resulting in reduced expression of the sodium-iodide symporter and other proteins involved in iodine metabolism 1 This difference in iodine uptake has significant clinical implications, affecting both diagnostic scanning and radioactive iodine therapy effectiveness, with well-differentiated tumors generally being more amenable to radioiodine-based approaches than poorly differentiated ones 2, 3. Some key points to consider include:
- The use of radioactive iodine in the treatment of thyroid cancer, particularly in patients with differentiated papillary and follicular thyroid cancer 4, 2
- The importance of selective use of radioactive iodine in the postoperative management of patients with papillary and follicular thyroid carcinoma, tailoring treatment to individual patient risk 3
- The role of histone deacetylase inhibitors, such as Trichostatin A, in increasing the effectiveness of radioactive iodine therapy by enhancing NIS expression and reducing Pendrin activity 1