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Journal Publication
Title of Article Prevalence and determinants of misclassification of the risk of recurrence of differentiated thyroid cancer after the first 131I post-therapeutic scintigraphy 
Date of Acceptance 19 January 2021 
Journal
     Title of Journal Asia-Pacific Journal of Science and Technology 
     Standard SCOPUS 
     Institute of Journal The Research and Technology Transfer Affairs Division of Khon Kaen University 
     ISBN/ISSN 2539-6293 
     Volume 26 
     Issue
     Month APR-JUN
     Year of Publication 2021 
     Page  
     Abstract 131I total body scintigraphy has long been used for imaging the extent of disease in differentiated thyroid cancer (DTC). Currently, the risk of recurrence of DTC is stratified into low-, intermediate-, and high-risk based on pathological findings. In practice, 131I post-therapeutic scintigraphy after the first 131I treatment tends to detect additional cervical lymph node metastasis and/or distant functioning metastasis, which can guide the treatment, hence having a high impact on clinical outcome. The aim of our study is, therefore, to explore the prevalence of misclassification of the risk stratification system after the first dose of 131I therapy and to determine the factors associate with it. Misclassification was defined as the difference of the risk stratification between the one based on pathological findings and the other based on 131I post-therapeutic scintigraphy. Total of 360 patients was included. Of these, 57 patients were misclassified (15.8%). That is, 39 (10.8%) in the low-risk group should be in the intermediate group, 2 (0.6%) patients in the low-risk group should be in the high risk, and 16 (4.4%) patients in the intermediate group should be in the high-risk group. The baseline stimulated thyroglobulin (Tg) level of ≥ 10 ng/mL showed a strong association with the misclassification (OR=3.2, 95%CI: 1.4 to 7.5; p=0.007). In conclusion, detection of considerable number of misclassification in risk stratification of DTC has raised awareness of the under-prescription of 131I doses. Attention should be paid to patients with a high baseline stimulated Tg level of greater than 10 ng/mL. 
     Keyword Differentiated thyroid cancer, Radioiodine, 131I scintigraphy, Risk of recurrence, Misclassification 
Author
607110012-4 Miss NANTAPORN WONGSURAWAT [Main Author]
Public Health Doctoral Degree

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