Thyroid cancer is the most common oncological pathology of the endocrine system organs with a continuing trend towards an increase in the incidence. Radioiodine therapy (RIT) is the second stage of combined treatment, it is carried out only as an adjuvant treatment, it is an uncontested method of radio-targeted therapy for distant metastases of differentiated thyroid cancer (DTC). The method of radioiodine therapy is based on the unique natural affinity of iodine atoms for the follicular epithelium of the thyroid gland and DTC cells. Determination of indications for RIT is based on stratification of recurrence risk, persistence, and disease prevalence. Over the past 15 years, the world’s leading professional communities have repeatedly revised approaches to risk stratification. Consideration of the mutational profile of the tumor and the theranostic approach have become significant innovations.Radioiodine therapy can be presented in the form of three modes: ablation of residual thyroid tissue, treatment of residual tumor and treatment of distant metastases. These regimens differ in the administered therapeutic activity of 131I, which looks logical from the point of view of the necessary personalization of the treatment. At the same time, in scientific circles, disputes about the absence of significant differences in the used therapeutic activities of 131I prescribed for radioiodine ablation outside the personalized approach do not subside.
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