Impact of serum TRAb level changes on the efficacy of 131I therapy in Graves’ disease: a decision tree prediction model

ObjectivesThis study aims to evaluate the relationship between changes in thyroid stimulating hormone receptor antibody (TRAb) levels before and after treatment and the efficacy of radioactive iodine therapy (RAI) for Graves’ disease (GD). Additionally, a decision tree model was developed to predict...

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Main Authors: Ziyu Ma, Nan Liu, Yiwang Du, Xuan Wang, Xue Li, Shasha Hou, Zhaowei Meng, Jian Tan, Wei Zheng
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Endocrinology
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Online Access:https://www.frontiersin.org/articles/10.3389/fendo.2025.1581353/full
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author Ziyu Ma
Nan Liu
Yiwang Du
Xuan Wang
Xue Li
Shasha Hou
Zhaowei Meng
Jian Tan
Wei Zheng
author_facet Ziyu Ma
Nan Liu
Yiwang Du
Xuan Wang
Xue Li
Shasha Hou
Zhaowei Meng
Jian Tan
Wei Zheng
author_sort Ziyu Ma
collection DOAJ
description ObjectivesThis study aims to evaluate the relationship between changes in thyroid stimulating hormone receptor antibody (TRAb) levels before and after treatment and the efficacy of radioactive iodine therapy (RAI) for Graves’ disease (GD). Additionally, a decision tree model was developed to predict treatment outcomes based on variations in serum TRAb levels.MethodsA total of 728 patients were evaluated to investigate the association between TRAb level fluctuations and RAI treatment efficacy. A decision tree model was constructed using TRAb level changes at 3 and 6 months post-RAI to predict clinical outcomes.ResultsAmong the 728 patients, 326 (44.8%) achieved clinical remission. Patients with lower TRAb levels at 18 months post-RAI exhibited higher remission rates, particularly those whose TRAb levels returned to baseline. A greater decline in TRAb levels between 18 and 36 months post-RAI was also correlated with improved treatment outcomes. Decision tree models based on TRAb level changes at the 3rd and the 6th month post-RAI demonstrated predictive accuracies of 74.36% and 72.46%, respectively. Further analysis showed that patients with minimal TRAb elevation in the early phase after RAI had a higher likelihood of achieving remission.ConclusionsDecision tree modeling identified early TRAb elevation patterns that serve as strong predictors of RAI efficacy. Incorporating TRAb fluctuations into clinical assessment may facilitate personalized 131I dosing strategies, ultimately improving treatment outcomes for GD patients.
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spelling doaj-art-3c98d92763584d8dae4cc61872f1e8bb2025-08-20T02:38:26ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-07-011610.3389/fendo.2025.15813531581353Impact of serum TRAb level changes on the efficacy of 131I therapy in Graves’ disease: a decision tree prediction modelZiyu Ma0Nan Liu1Yiwang Du2Xuan Wang3Xue Li4Shasha Hou5Zhaowei Meng6Jian Tan7Wei Zheng8Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, ChinaDepartment of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, ChinaDepartment of Rheumatology and Immunology, Tianjin Medical University General Hospital, Tianjin, ChinaDepartment of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, ChinaDepartment of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, ChinaDepartment of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, ChinaDepartment of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, ChinaDepartment of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, ChinaDepartment of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, ChinaObjectivesThis study aims to evaluate the relationship between changes in thyroid stimulating hormone receptor antibody (TRAb) levels before and after treatment and the efficacy of radioactive iodine therapy (RAI) for Graves’ disease (GD). Additionally, a decision tree model was developed to predict treatment outcomes based on variations in serum TRAb levels.MethodsA total of 728 patients were evaluated to investigate the association between TRAb level fluctuations and RAI treatment efficacy. A decision tree model was constructed using TRAb level changes at 3 and 6 months post-RAI to predict clinical outcomes.ResultsAmong the 728 patients, 326 (44.8%) achieved clinical remission. Patients with lower TRAb levels at 18 months post-RAI exhibited higher remission rates, particularly those whose TRAb levels returned to baseline. A greater decline in TRAb levels between 18 and 36 months post-RAI was also correlated with improved treatment outcomes. Decision tree models based on TRAb level changes at the 3rd and the 6th month post-RAI demonstrated predictive accuracies of 74.36% and 72.46%, respectively. Further analysis showed that patients with minimal TRAb elevation in the early phase after RAI had a higher likelihood of achieving remission.ConclusionsDecision tree modeling identified early TRAb elevation patterns that serve as strong predictors of RAI efficacy. Incorporating TRAb fluctuations into clinical assessment may facilitate personalized 131I dosing strategies, ultimately improving treatment outcomes for GD patients.https://www.frontiersin.org/articles/10.3389/fendo.2025.1581353/fullGraves’ diseaseradioactive iodine therapyTRAbdecision treeefficacyprediction model
spellingShingle Ziyu Ma
Nan Liu
Yiwang Du
Xuan Wang
Xue Li
Shasha Hou
Zhaowei Meng
Jian Tan
Wei Zheng
Impact of serum TRAb level changes on the efficacy of 131I therapy in Graves’ disease: a decision tree prediction model
Frontiers in Endocrinology
Graves’ disease
radioactive iodine therapy
TRAb
decision tree
efficacy
prediction model
title Impact of serum TRAb level changes on the efficacy of 131I therapy in Graves’ disease: a decision tree prediction model
title_full Impact of serum TRAb level changes on the efficacy of 131I therapy in Graves’ disease: a decision tree prediction model
title_fullStr Impact of serum TRAb level changes on the efficacy of 131I therapy in Graves’ disease: a decision tree prediction model
title_full_unstemmed Impact of serum TRAb level changes on the efficacy of 131I therapy in Graves’ disease: a decision tree prediction model
title_short Impact of serum TRAb level changes on the efficacy of 131I therapy in Graves’ disease: a decision tree prediction model
title_sort impact of serum trab level changes on the efficacy of 131i therapy in graves disease a decision tree prediction model
topic Graves’ disease
radioactive iodine therapy
TRAb
decision tree
efficacy
prediction model
url https://www.frontiersin.org/articles/10.3389/fendo.2025.1581353/full
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