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Anna Olsson-Brown Department of Molecular and Clinical Pharmacology, University of Liverpool, Liverpool, UK
The Clatterbridge Cancer Centre, Wirral, UK

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Rosemary Lord The Clatterbridge Cancer Centre, Wirral, UK

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Joseph Sacco The Clatterbridge Cancer Centre, Wirral, UK
Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK

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Jonathan Wagg Roche Innovation Center, Basel, Switzerland

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Mark Coles Kennedy Institute of Rheumatology, University of Oxford, Oxford, UK

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Munir Pirmohamed Department of Molecular and Clinical Pharmacology, University of Liverpool, Liverpool, UK

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monotherapy ICI was 12 weeks (range 6–18 weeks; IQR 6 weeks). The trough T4 prior to commencement of levothyroxine was 4.45 pmol/L (95% CI 0.4–8.5 pmol/L), with an associated peak TSH of 69.0 mU/L (95% CI 44.7–93.2 mU/L). Figure 2 Changes of TSH (black

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Xiaoya Zheng Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China

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Shanshan Yu Pathology Department, Chongqing Medical University, Chongqing, China

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Jian Long Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China

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Qiang Wei Prevention of Disease Department, Chongqing Jiulongpo District Hospital of Traditional Chinese Medicine, Chongqing, China

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Liping Liu Department of Ultrasound, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China

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Chun Liu Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China

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Wei Ren Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China

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having an elevated TSH value >5.91 µIU/mL or being on levothyroxine replacement therapy at the time of diagnosis. The diagnosis of HT was suggested by a typical ultrasound pattern or by the presence of antithyroid antibodies ( 17 ). Statistical

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Amir Bashkin Department of Endocrinology, Galilee Medical Center, Nahariya, Israel
Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel

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Eliran Yaakobi Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel

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Marina Nodelman Department of Endocrinology, Galilee Medical Center, Nahariya, Israel
Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel

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Ohad Ronen Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
Department of Otolaryngology Head and Neck Surgery, Galilee Medical Center, Nahariya, Israel

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glucocorticoids, levothyroxine, Mercaptizol, Propylthiouracil, Amiodarone, opioids and drugs that enhance T4 metabolism through the enhancement of cytochrome P450 3A4 such as phenytoin and carbamazepine ( 5 , 6 ). Patients were divided into the following

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Adriano N Cury Pediatric Endocrinology Unit, Endocrinology and Metabolism, Nuclear Medicine Laboratory, Pediatrics Department, Irmandade da Santa Casa de Misericórdia de São Paulo, 01221-020 São Paulo, Brazil

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Verônica T Meira Pediatric Endocrinology Unit, Endocrinology and Metabolism, Nuclear Medicine Laboratory, Pediatrics Department, Irmandade da Santa Casa de Misericórdia de São Paulo, 01221-020 São Paulo, Brazil

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Osmar Monte Pediatric Endocrinology Unit, Endocrinology and Metabolism, Nuclear Medicine Laboratory, Pediatrics Department, Irmandade da Santa Casa de Misericórdia de São Paulo, 01221-020 São Paulo, Brazil
Pediatric Endocrinology Unit, Endocrinology and Metabolism, Nuclear Medicine Laboratory, Pediatrics Department, Irmandade da Santa Casa de Misericórdia de São Paulo, 01221-020 São Paulo, Brazil

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Marília Marone Pediatric Endocrinology Unit, Endocrinology and Metabolism, Nuclear Medicine Laboratory, Pediatrics Department, Irmandade da Santa Casa de Misericórdia de São Paulo, 01221-020 São Paulo, Brazil

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Nilza M Scalissi Pediatric Endocrinology Unit, Endocrinology and Metabolism, Nuclear Medicine Laboratory, Pediatrics Department, Irmandade da Santa Casa de Misericórdia de São Paulo, 01221-020 São Paulo, Brazil

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Cristiane Kochi Pediatric Endocrinology Unit, Endocrinology and Metabolism, Nuclear Medicine Laboratory, Pediatrics Department, Irmandade da Santa Casa de Misericórdia de São Paulo, 01221-020 São Paulo, Brazil

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Luís E P Calliari Pediatric Endocrinology Unit, Endocrinology and Metabolism, Nuclear Medicine Laboratory, Pediatrics Department, Irmandade da Santa Casa de Misericórdia de São Paulo, 01221-020 São Paulo, Brazil

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Carlos A Longui Pediatric Endocrinology Unit, Endocrinology and Metabolism, Nuclear Medicine Laboratory, Pediatrics Department, Irmandade da Santa Casa de Misericórdia de São Paulo, 01221-020 São Paulo, Brazil

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medications. Treatment period of ATD therapy was 16.9 (11.4) months. Levothyroxine ( l -T 4 ) was used in all patients who progressed to hypothyroidism after RAI therapy. No patient was subjected to ‘block and replace’ treatment. The chief criteria that were

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Paolo G Arduino Department of Surgical Sciences, CIR-Dental School, University of Turin, Turin, Italy

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Dora Karimi Department of Surgical Sciences, CIR-Dental School, University of Turin, Turin, Italy

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Federico Tirone Private Practice, Cuneo, Italy

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Veronica Sciannameo Unit of Epidemiology, Regional Health Service ASL TO3, Grugliasco, Turin, Italy

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Fulvio Ricceri Unit of Epidemiology, Regional Health Service ASL TO3, Grugliasco, Turin, Italy

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Marco Cabras Department of Surgical Sciences, CIR-Dental School, University of Turin, Turin, Italy

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Alessio Gambino Department of Surgical Sciences, CIR-Dental School, University of Turin, Turin, Italy

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Davide Conrotto Department of Surgical Sciences, CIR-Dental School, University of Turin, Turin, Italy

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Stefano Salzano Private Practice, Cuneo, Italy

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Mario Carbone Department of Surgical Sciences, CIR-Dental School, University of Turin, Turin, Italy

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Roberto Broccoletti Department of Surgical Sciences, CIR-Dental School, University of Turin, Turin, Italy

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consider normal function of the thyroid gland, were between 9.0 and 25.0 pmol/L for fT 4 , and between 0.4 and 4.0 milliunits per litre (U/L) for TSH. Patients with the abnormal test were referred to an endocrinologist. Levothyroxine was the most commonly

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Sophie Howarth Clinical and Translational Research Institute, Newcastle University, Newcastle upon Tyne, UK
Department of Endocrinology, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK

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Luca Giovanelli Department of Endocrinology, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK

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Catherine Napier Department of Endocrinology, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK

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Simon H Pearce Clinical and Translational Research Institute, Newcastle University, Newcastle upon Tyne, UK
Department of Endocrinology, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK

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history included levothyroxine 200 µg once daily, 3-monthly vitamin B12 injections, an actrapid/glargine basal bolus insulin regimen and the combined oral contraceptive pill (COCP). Eight years previously, she had been hospitalised for an episode of

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Selma Flora Nordqvist Department of Medical Endocrinology and Metabolism, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark

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Victor Brun Boesen Department of Medical Endocrinology and Metabolism, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark

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Åse Krogh Rasmussen Department of Medical Endocrinology and Metabolism, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark

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Ulla Feldt-Rasmussen Department of Medical Endocrinology and Metabolism, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark

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Laszlo Hegedüs Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark

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Steen Joop Bonnema Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark

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Per Karkov Cramon Department of Clinical Physiology and Nuclear Medicine, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark

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Torquil Watt Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
Department of Internal Medicine, Herlev Gentofte Hospital, Copenhagen, Denmark

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Mogens Groenvold Department of Public Health, University of Copenhagen, Copenhagen, Denmark
Department of Palliative Medicine, Bispebjerg Hospital, Copenhagen, Denmark

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Jakob Bue Bjorner Department of Public Health, University of Copenhagen, Copenhagen, Denmark
National Research Centre for the Working Environment, Copenhagen, Denmark
QualityMetric Incorporated, LLC, Johnston, Rhode Island, USA

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)  Autoimmune hypothyroidism 86 (20)  Other thyroid diagnoses 18 (4) Disease duration (months) 0.3 (0–4) Treatment instituted  Levothyroxine 111 (26)  Antithyroid medication 86 (20)  Aspiration of thyroid cyst 4

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Hanna Karhapää Medical Faculty, University of Helsinki, Helsinki, Finland
Department of Oncology, Comprehensive Cancer Centre, Helsinki University Hospital, Helsinki, Finland

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Siru Mäkelä Medical Faculty, University of Helsinki, Helsinki, Finland
Department of Oncology, Comprehensive Cancer Centre, Helsinki University Hospital, Helsinki, Finland

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Hanna Laurén Medical Faculty, University of Helsinki, Helsinki, Finland
Department of Radiology, HUS Medical Imaging Centre, University of Helsinki and Helsinki University Hospital, Helsinki, Finland

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Marjut Jaakkola Medical Faculty, University of Helsinki, Helsinki, Finland
Department of Radiology, HUS Medical Imaging Centre, University of Helsinki and Helsinki University Hospital, Helsinki, Finland

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Camilla Schalin-Jäntti Medical Faculty, University of Helsinki, Helsinki, Finland
Endocrinology, Abdominal Centre, University of Helsinki and HUS, Helsinki, Finland

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Micaela Hernberg Medical Faculty, University of Helsinki, Helsinki, Finland
Department of Oncology, Comprehensive Cancer Centre, Helsinki University Hospital, Helsinki, Finland

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patients (12%) had a borderline level of TSHRAbs, and 7 patients (5%) had elevated TPOAbs. Prior to ICI treatment, 19 patients (14%) had primary hypothyroidism and were on levothyroxine treatment. None of the patients with a previous diagnosis of

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Lian Duan Department of Nuclear Medicine, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, Shanxi, China

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Han-Yu Zhang Changzhi Medical College, Changzhi, Shanxi, China

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Min Lv Department of Nuclear Medicine, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, Shanxi, China

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Han Zhang Changzhi Medical College, Changzhi, Shanxi, China

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Yao Chen Changzhi Medical College, Changzhi, Shanxi, China

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Ting Wang Department of Nuclear Medicine, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, Shanxi, China

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Yan Li Department of Nuclear Medicine, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, Shanxi, China

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Yan Wu Department of Clinical Laboratory, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China

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Junfeng Li Department of Radiology, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, Shanxi, China

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Kefeng Li School of Medicine, University of California, San Diego, California, USA

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and complex interactions among multiple predictive variables ( 15 ). However, to date, the application of machine learning approaches in thyroid-related diseases has primarily focused on the ultrasonic diagnosis or the optimization of levothyroxine

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W J Bom Department of Internal Medicine, Rijnstate Hospital, Arnhem, the Netherlands

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F B M Joosten Department of Radiology, Rijnstate Hospital, Arnhem, the Netherlands

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M M G J van Borren Department of Clinical Chemistry, Rijnstate Hospital, Arnhem, the Netherlands

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E P Bom Department of Radiology, Rijnstate Hospital, Arnhem, the Netherlands

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R R J P van Eekeren Department of Surgery, Rijnstate Hospital, Arnhem, the Netherlands

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H de Boer Department of Internal Medicine, Rijnstate Hospital, Arnhem, the Netherlands

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, and was treated with levothyroxine (50–125 µg daily). Two other patients were also on levothyroxine treatment, one because of Hashimoto’s disease and one because of hypothyroidism of unknown cause. The median nodule volume at baseline was 12.0 mL

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