Table 2.

Evolution of RAT in guidelines by clinicopathological features.

	ATA guidelines		2019 ESMO guidelines	NCCN guidelines			2022 ETA Consensus Statement
Indications	2009 ATA guidelines	2015 ATA guidelines		2018 NCCN guidelines	2020 NCCN guidelines	2021 NCCN guidelines
Clinicopathological features guided	Tumor >1.5 cm	(Updated on 2009 ATA Guidelines)	Intermediate-and high-risk	Clinicopathologic findings (+), Dx-WBS (-):	(Updated on 2018NCCN Guidelines)	(Updated on 2020NCCN Guidelines)	1. High-riskb *
	With post-operatively residual disease	1.1 Intermediate-riska	(Updated on 2015 ATA Guidelines)	1. Tumor >2cm;	1. RAT selectively recommended:		2. Intermediate-riskc
		1.2 High-riskb *	1. Intermediate-risk: Tumor-related symptoms	2. MVI (+)	Tumor 2–4 cm
		2. BRAFV600E	2. High-risk: TERT(+) and BRAFV600E (+)	3. cLNM (+)	2. RAT recommended*:
				4. Microscopic margins (+)	Tumor >4 cm
				5. ETE (+)	ETE (+)
					EVId
					Bulky or LNM >5	Dx-WBS (-), CT/MRI+
Dosage	100-200 mCi	30-150 mCi		50-100 mCi	50-200 mCi	50-100mCi
		T3&N1: the effectiveness of RAT >150 mCi is uncertain	Intermediate risk: 30-100 mCi		RAI for known disease (100-200mCi) is embodied in RAT (50-100mCi).		High-risk: ≥100mCi;
			High risk: 100 mCi				Intermediate-risk: the benefit of RAT≥100mCi is unclear

* routinely recommend.

^a Intermediate-risk with any of the following: aggressive histology, minor extrathyroidal extension, vascular invasion, or >5 involved lymph nodes(0.2-3 cm).

^b High-risk with any of the following: Gross extrathyroidal extension, incomplete tumor resection, distant metastases or lymph node >3 cm.

^c Intermediate-risk with any of the following: advanced age, aggressive histologies, increasing volume of nodal disease, extranodal extension, multiple N1 and/or lymph node metastases outside the central neck.

^d Extensive vascular invasion (minimally invasive HCC is characterized as an encapsulated tumor with microscopic capsular invasion and without vascular invasion).

Dx-WBS, ¹³¹I diagnostic whole-body scan; MVI, minor vascular invasion; cLNM, central lymph node metastases; ETE, extrathyroidal extension; EVI, extensive vascular invasion; CT, computed tomography; MRI, magnetic resonance imaging.