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Purpose <p>We performed an external validation of a predictive model for persistent/metastatic disease in patients with differentiated thyroid cancer (DTC) at post-treatment <sup>131</sup>I whole-body scintigraphy (WBS).</p> Methods <p>Our study population included 836 patients (median age 44&#xa0;years, 78% women) with DTC referred from 1994 to 2021 at our center. Age, sex, histology, T stage, N stage, American Thyroid Association risk classes, thyroid-stimulating hormone, radioactive iodine (RAI) activity, and thyroglobulin (Tg) levels were considered potential predictors of post-treatment WBS results. For the external validation, N stage and Tg levels were put into the decision tree (DT) model using its same Tg cut-off values.</p> Results <p>Ninety-nine patients (12%) had positive post-treatment WBS. The area under receiver operating characteristic (ROC) curve for predicting WBS findings through the external validation was 0.60 (95% confidence interval, CI, 0.56–0.64), and positive and negative predictive values were 58% (95% CI, 41–74%) and 90% (95% CI, 88–92%). We also developed an internal model including the independent predictors of WBS findings (i.e., Tg levels, T stage, N stage, and RAI activity). For this model the area under ROC curve was 0.75 (95% CI, 0.69–0.81), and positive and negative predictive values were 90% (95% CI, 68–99% and 88–92%).</p> Conclusions <p>The external validation of the proposed DT model has a limited value for predicting post-treatment <sup>131</sup>I-WBS findings in our patients. The internal model including also T stage and RAI activity demonstrates higher predictive value.</p>

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External validation of a predictive model for post-treatment persistent disease by 131I whole-body scintigraphy in patients with differentiated thyroid cancer

  • 期刊论文

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  • 发表日期：

    2025年2月25日

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  • Carmela Nappi,
  • Rosario Megna,
  • Emilia Zampella,
  • Fabio Volpe,
  • Leandra Piscopo,
  • Maria Falzarano,
  • Carlo Vallone,
  • Leonardo Pace,
  • Mario Petretta,
  • Alberto Cuocolo,
  • Michele Klain

摘要

Purpose

We performed an external validation of a predictive model for persistent/metastatic disease in patients with differentiated thyroid cancer (DTC) at post-treatment 131I whole-body scintigraphy (WBS).

Methods

Our study population included 836 patients (median age 44 years, 78% women) with DTC referred from 1994 to 2021 at our center. Age, sex, histology, T stage, N stage, American Thyroid Association risk classes, thyroid-stimulating hormone, radioactive iodine (RAI) activity, and thyroglobulin (Tg) levels were considered potential predictors of post-treatment WBS results. For the external validation, N stage and Tg levels were put into the decision tree (DT) model using its same Tg cut-off values.

Results

Ninety-nine patients (12%) had positive post-treatment WBS. The area under receiver operating characteristic (ROC) curve for predicting WBS findings through the external validation was 0.60 (95% confidence interval, CI, 0.56–0.64), and positive and negative predictive values were 58% (95% CI, 41–74%) and 90% (95% CI, 88–92%). We also developed an internal model including the independent predictors of WBS findings (i.e., Tg levels, T stage, N stage, and RAI activity). For this model the area under ROC curve was 0.75 (95% CI, 0.69–0.81), and positive and negative predictive values were 90% (95% CI, 68–99% and 88–92%).

Conclusions

The external validation of the proposed DT model has a limited value for predicting post-treatment 131I-WBS findings in our patients. The internal model including also T stage and RAI activity demonstrates higher predictive value.