{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T14:42:07Z","timestamp":1783780927809,"version":"3.55.0"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,8,20]],"date-time":"2024-08-20T00:00:00Z","timestamp":1724112000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p>To develop a predictive model using machine learning for levothyroxine (L-T4) dose selection in patients with differentiated thyroid cancer (DTC) after resection and radioactive iodine (RAI) therapy and to prospectively validate the accuracy of the model in two institutions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 266 DTC patients who received RAI therapy after thyroidectomy and achieved target thyroid stimulating hormone (TSH) level were included in this retrospective study. Sixteen clinical and biochemical characteristics that could potentially influence the L-T4 dose were collected; Significant features correlated with L-T4 dose were selected using machine learning random forest method, and a total of eight regression models were established to assess their performance in prediction of L-T4 dose after RAI therapy; The optimal model was validated through a two-center prospective study (n=263).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Six significant clinical and biochemical features were selected, including body surface area (BSA), weight, hemoglobin (HB), height, body mass index (BMI), and age. Cross-validation showed that the support vector regression (SVR) model was with the highest accuracy (53.4%) for prediction of L-T4 dose among the established eight models. In the two-center prospective validation study, a total of 263 patients were included. The TSH targeting rate based on constructed SVR model were dramatically higher than that based on empirical administration (Rate 1 (first rate): 52.09% (137\/263) vs 10.53% (28\/266); Rate 2 (cumulative rate): 85.55% (225\/263) vs 53.38% (142\/266)). Furthermore, the model significantly shortens the time (days) to achieve target TSH level (62.61 \u00b1 58.78 vs 115.50 \u00b1 71.40).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The constructed SVR model can effectively predict the L-T4 dose for postoperative DTC after RAI therapy, thus shortening the time to achieve TSH target level and improving the quality of life for DTC patients.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2024.1425101","type":"journal-article","created":{"date-parts":[[2024,8,20]],"date-time":"2024-08-20T04:30:04Z","timestamp":1724128204000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["A predictive model for L-T4 dose in postoperative DTC after RAI therapy and its clinical validation in two institutions"],"prefix":"10.3389","volume":"15","author":[{"given":"Jian-Jing","family":"Liu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zi-Yang","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan-Fang","family":"Yue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guo-Tao","family":"Yin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-Na","family":"Tong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Fu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Ying","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xue-Yao","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-Bo","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian","family":"Su","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhao","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Feng","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen-Gui","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong","family":"Dai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,8,20]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2019.0067","article-title":"Efficacy and safety of long-term universal salt iodization on thyroid disorders: Epidemiological evidence from 31 provinces of mainland China","volume":"30","author":"Li","year":"2020","journal-title":"Thyroid"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.2719","article-title":"et al. Trends in thyroid cancer incidence and mortality in the United States, 1974-2013","volume":"317","author":"Lim","year":"2017","journal-title":"JAMA"},{"key":"B3","doi-asserted-by":"publisher","first-page":"181","DOI":"10.3760\/cma.j.cn311282-20221023-00589","article-title":"Guidelines for the diagnosis and management of thyroid nodules and differentiated thyroid cancer (Second edition 2023)","volume":"39","year":"2023","journal-title":"Chin J Endocrinol Metab"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2006-2566","article-title":"Associations of serum thyrotropin concentrations with recurrence and death in differentiated thyroid cancer","volume":"92","author":"Hovens","year":"2007","journal-title":"J Clin Endocrinol Metab"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1210\/JC.2015-1346","article-title":"Long-term outcomes following therapy in differentiated thyroid carcinoma: NTCTCS registry analysis 1987-2012","volume":"100","author":"Carhill","year":"2015","journal-title":"J Clin Endocrinol Metab"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1089\/thy.1998.8.737","article-title":"Thyrotropin suppression and disease progression in patients with differentiated thyroid cancer: results from the National Thyroid Cancer Treatment Cooperative Registry","volume":"8","author":"Cooper","year":"1998","journal-title":"Thyroid"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1089\/thy.2015.0020","article-title":"American thyroid association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: The American thyroid association guidelines task force on thyroid nodules and differentiated thyroid cancer","volume":"26","author":"Haugen","year":"2015","journal-title":"Thyroid"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.3760\/cma.j.issn.2095-2848.2014.04.002","article-title":"Clinical guidelines for 131I therapy of differentiated thyroid cancer (2014 Edition)","volume":"34","year":"2014","journal-title":"Chin J Nuclear Med Mol Imaging"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2020.626268","article-title":"Levothyroxine therapy in thyrodectomized patients","volume":"11","author":"Miccoli","year":"2020","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B10","doi-asserted-by":"publisher","first-page":"208","DOI":"10.1186\/s12902-021-00871-x","article-title":"A multicenter, prospective study to observe the initial management of patients with differentiated thyroid cancer in China (DTCC study)","volume":"21","author":"Ming","year":"2021","journal-title":"BMC Endocr Disord"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.6039\/j.issn.1001-0408.2019.03.21","article-title":"Investigation of prediction model for optimal initial dose of levothyroxine in differentiated thyroid cancer patients after surgery","volume":"30","author":"Li","year":"2019","journal-title":"China Pharmacy"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2018.04.097","article-title":"The optimal dosing scheme for levothyroxine after thyroidectomy: A comprehensive comparison and evaluation","volume":"165","author":"Zaborek","year":"2019","journal-title":"Surgery"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-019-05523-4","article-title":"Optimal levothyroxine dose in post-total thyroidectomy patients: a prediction model for initial dose titration","volume":"276","author":"Al-Dhahri","year":"2019","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2015.10.005","article-title":"Prospective intervention of a novel levothyroxine dosing protocol based on body mass index after thyroidectomy","volume":"222","author":"Elfenbein","year":"2016","journal-title":"J Am Coll Surg"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2012.10.015","article-title":"Levothyroxine replacement dosage determination after thyroidectomy","volume":"205","author":"Jin","year":"2013","journal-title":"Am J Surg"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2021.0125","article-title":"Patient-tailored levothyroxine dosage with pharmacokinetic\/pharmacodynamic modeling: A novel approach after total thyroidectomy","volume":"31","author":"Brun","year":"2021","journal-title":"Thyroid"},{"key":"B17","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1002\/bjs.5157","article-title":"Optimization of thyroxine replacement therapy after total or near-total thyroidectomy for benign thyroid disease","volume":"93","author":"Olubowale","year":"2006","journal-title":"Br J Surg"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2019.06.025","article-title":"Optimizing levothyroxine dose adjustment after thyroidectomy with a decision tree","volume":"244","author":"Chen","year":"2019","journal-title":"J Surg Res"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1111\/cen.2011.74.issue-3","article-title":"Predicting thyroxine requirements following total thyroidectomy","volume":"74","author":"Mistry","year":"2011","journal-title":"Clin Endocrinol (Oxf)"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2012.12.002","article-title":"Using body mass index to predict optimal thyroid dosing after thyroidectomy","volume":"216","author":"Ojomo","year":"2013","journal-title":"J Am Coll Surg"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2014.0111","article-title":"A new strategy to estimate levothyroxine requirement after total thyroidectomy for benign thyroid disease","volume":"24","author":"Di Donna","year":"2014","journal-title":"Thyroid"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2023.0033","article-title":"Computer-assisted levothyroxine dose selection for the treatment of postoperative hypothyroidism","volume":"33","author":"Barrio","year":"2023","journal-title":"Thyroid"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2024.1425101\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,20]],"date-time":"2024-08-20T04:30:14Z","timestamp":1724128214000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2024.1425101\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,20]]},"references-count":22,"alternative-id":["10.3389\/fendo.2024.1425101"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2024.1425101","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,20]]},"article-number":"1425101"}}