甲状腺癌（TC）是最常见的内分泌恶性肿瘤，发病率不断上升。放射性碘消融是治疗 TC 的一种安全有效的方法。最近发布了关于谁应该被消融、何时以及在何种情况下消融的各种指南（GL）。我们的研究将 6 GL 与给定的患者队列进行了比较。此外，我们通过独立工具评估了每个 GL 的质量。我们在 336 名患者的队列中比较了 6 个 TC 消融指南 (GL)，回顾性实施 GL：2009 年和 2016 年美国甲状腺协会 (ATA)、欧洲甲状腺协会 (ETA) 共识英国国家健康与护理卓越研究所 (NICE) 的声明、外科与核医学（德国）以及欧洲核医学协会和核医学与分子影像学会 (EANM/SNMMI) 的德国立场文件。使用指南评估、研究和评估工具 II (AGREE II) 进行质量评估。结果显示 GL 之间存在显着差异。美国甲状腺协会 2016 年报告是 ATA 2009 年报告的明显改进，提出了“可能的消融候选者”的大片灰色区域。欧洲甲状腺协会和 NICE 一致认为，我们的消融患者中只有一小部分会从中受益，AGREE II 工具显示缺乏适用性，但在其他地方得分非常好。 German 和 EANM/SNMMI GL 一致认为，我们大多数的临床消融决策都是正确的，并且他们的 AGREE II 评分在所有六个领域中都是最高的。考虑到动态风险分类在确定最合适的治疗方面发挥着重要作用，看来应更新指南以支持个体化患者管理。然而，最终决定将由个别医生的经验决定。

Thyroid cancer (TC) is the most common endocrine malignancy with constantly growing incidence. Radioiodine ablation is a safe and effective method for managing TC. Recently various Guidelines (GL) have been published on whom should be ablated, when and under which circumstances. Our study compares 6 GL with a given patient cohort. Additionally, we evaluated each GL's quality via an independent tool.We compared six Guidelines (GL) for TC ablation on a cohort of 336 patients, implementing GL retrospectively: 2009 and 2016 American Thyroid Association (ATA), European Thyroid Association's (ETA) Consensus Statement, UK's National Institute for Health and Care Excellence (NICE), German position paper from Surgery and Nuclear Medicine (German) and European Association of Nuclear Medicine and Society of Nuclear Medicine and Molecular Image (EANM/SNMMI). Quality assessment was conducted using the Appraisal of Guidelines, Research and Evaluation instrument II (AGREE II).Results showed significant variability among GL. American Thyroid Association 2016, a clear improvement of the ATA 2009, presents a large grey area of "probable ablation candidates". European Thyroid Association and NICE agree that only a small portion of our ablated patients would benefit from it and the AGREE II tool shows a lack of applicability, but very good scores elsewhere. German and EANM/SNMMI GL agree that most of our clinical decisions to ablate were correct and their AGREE II scores are the highest in all six domains.Considering that dynamic risk classification plays a major role in determining the most appropriate treatment, it appears that the guidelines should be updated in order to support individualized patient management. However, it is the experience of the individual physician that will determine the final decision.