Management of adenomas and toxic multinodular goiters with Iodine 131

Abstract In accordance with all the guidelines of the various international scientific societies, treatment using radioiodine (RAI) of autonomous toxic adenomas and toxic multinodular goiters is highly recommended and its effectiveness its efficacy has now been widely demonstrated and established. RAI treatment is effective to normalise thyroid function, remove functional autonomy and reduce thyroid volume. According to published data on several thousand patients treated with RAI, the success rates ranges between 85% and 100%. Moreover, with more than 70 years of experience, this treatment does not present any particular risk for patients. However, as regards pregnancy, there are no absolute contra-indications to radioiodine treatment. To date, these results include a relatively high rate of hypothyroidism in the long term and approximately one patient out of five treated, will require thyroid hormone substitution. It would be more effective to harmonise and work up on dosimetric personalized models allowing the calculation of the effective dose to be delivered to the autonomous nodule to be treated while preserving the normal thyroid parenchyma in order to optimise the patient's outcome and to favor extensive euthyroidism.