Greenspan Bennett S, Hofman Michael S, Buscombe John
Department of Radiology, Augusta VA Medical Center, Augusta, Georgia;
Prostate Cancer Theranostics and Imaging Centre of Excellence, Department of Molecular Imaging and Therapeutic Nuclear Medicine Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
J Nucl Med. 2024 Apr 1;65(4):659-663. doi: 10.2967/jnumed.124.267524.
The early history of the use of radioactive iodine (RAI) is complicated and interesting, and also difficult to discover, especially since several histories have presented inaccurate content. This article is a comprehensive review of the accomplishments of Saul Hertz. Extensive use of primary-source verification has clarified several issues, including the question of whether Hertz alone conceived and asked the pivotal question: "Could iodine be made radioactive artificially?"; on what date RAI was first used to treat hyperthyroidism; and why 2 articles on the first use of RAI for treatment of hyperthyroidism, from 2 different sets of authors from the same department of the same institution, appeared adjacent to each other in the same issue of the in 1946. Our review also chronicles several major challenges that Hertz overcame to produce his pivotal work. Hertz was clearly the originator and a visionary of RAI therapy in benign and malignant thyroid disease. We believe he can be considered one of the fathers of nuclear medicine. Hertz's paradigm-changing work was a pivotal medical discovery of the 20th century. The legacy of Hertz continues while the application of RAI therapy continues to evolve. RAI therapy remains the preferred treatment in most situations for autonomous nodules and toxic multinodular goiter and remains a safe and effective treatment for Graves disease after more than 80 y of global clinical use. RAI treatment of differentiated thyroid cancer remains a first-line treatment for most patients after surgery, especially for those with intermediate- or high-risk disease.
放射性碘（RAI）早期的使用历史复杂且有趣，同时也难以探寻，特别是因为有几份历史记载呈现了不准确的内容。本文全面回顾了索尔·赫兹（Saul Hertz）的成就。通过广泛使用原始资料核实，澄清了几个问题，包括赫兹是否独自构思并提出了关键问题：“能否人工制造放射性碘？”；放射性碘首次用于治疗甲状腺功能亢进症的日期；以及为什么来自同一机构同一科室的两组不同作者撰写的关于放射性碘首次用于治疗甲状腺功能亢进症的两篇文章，会在1946年同一期的《 》中相邻出现。我们的回顾还记录了赫兹为完成其关键工作所克服的几个重大挑战。赫兹显然是良性和恶性甲状腺疾病放射性碘治疗的开创者和有远见者。我们认为他可被视为核医学之父之一。赫兹改变范式的工作是20世纪一项关键的医学发现。随着放射性碘治疗的应用不断发展，赫兹的遗产仍在延续。在全球临床应用80多年后，放射性碘治疗在大多数情况下仍是自主性结节和毒性多结节性甲状腺肿的首选治疗方法，并且仍是格雷夫斯病安全有效的治疗方法。放射性碘治疗分化型甲状腺癌对大多数患者术后而言仍是一线治疗方法，尤其是对那些患有中高危疾病的患者。
