Introduction:

Radioiodine (RAI) therapy of the thyroid diseases has been used for seven decades. However, there is no consensus regarding indications, doses, procedures, and other aspects related to the clinical care of the patients considered for 131I therapy. The reason for this is the lack of large well-designed prospective clinical trials resolving fundamental questions in relation to 131I therapy, despite the high prevalence of thyroid diseases. Radioiodine therapy is indicated for the treatment of hyperthyroidism (Graves'disease, toxic nodular goiter and toxic multinodular goiter), multinodular nontoxic goiter and differentiated thyroid carcinoma (DTC). In benign thyroid diseases, RAI is administered to decrease the thyroid function and/or reduction of the thyroid volume. In DTC, post-operative administration of RAI may include remnant ablation to eliminate residual normal thyroid tissue after thyroidectomy, adjuvant therapy to destroy suspected, but unproven residual disease and RAI therapy to treat persistent disease in higher risk patients. Pending the results of the prospective clinical trials that are currently underway, the use of 131I seems to be justified not only in high-risk patients, but also in low-intermediate-risk patients.

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