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Due to its mode of beta decay, iodine-131 is notable for causing mutation and death in cells that it penetrates, and other cells up to several millimeters away.

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Irradiation of natural tellurium produces almost entirely I-131 as the only radionuclide with a half-life longer than hours, since most lighter isotopes of tellurium become heavier stable isotopes, or else stable iodine or xenon.

However, the heaviest naturally occurring tellurium nuclide, Te-130 (34% of natural Te) absorbs a neutron to become tellurium-131, which beta-decays with a half-life of 25 minutes, to I-131.

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 (see isotopes of iodine) 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.

For example, children treated with moderate dose of I-131 for thyroid adenomas had a detectable increase in thyroid cancer, but children treated with a much higher dose did not.

Likewise, most studies of very-high-dose I-131 for treatment of Graves disease have failed to find any increase in thyroid cancer, even though there is linear increase in thyroid cancer risk with I-131 absorption at moderate doses.

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These studies suppose that cancers happen from residual tissue radiation damage caused by the I-131, and should appear mostly years after exposure, long after the I-131 has decayed.

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