407 Health-related quality of life following [18F]FDG-PET/CT 7 and cosmetic complaints scales, and the EQ-5D-5L and RAND-36 PCS. Goitre symptoms and anxiety had improved beyond baseline levels at the 12-month assessment. The observed deteriorations in HRQoL during the 3-month assessment are likely attributable to the diagnostic surgery and the first weeks postoperative, considering the 4-week recall periods of the RAND-36 and ThyPRO [595-597]. As presented in Table 1, diagnostic surgery was performed after a median of 1.8 months in patients with benign histopathology and 1.9 months in patients with malignancy. Our findings are in line with previous studies that demonstrated a temporary decrease in HRQoL following thyroid surgery and subsequent improvement up to 12 months postoperatively, including an improvement in goitre symptoms and anxiety [526, 580, 584-588]. Visual assessment of Figures 2-4 suggests that patients with malignant histopathology perceived a persistent decrease in HRQoL at 6 months, which was statistically significantly lower as compared to baseline for the ThyPRO cognitive impairment and impaired daily life scales, EQ-5D-5L, and RAND36 physical role functioning. These within-group HRQoL effects may be related to the completion thyroidectomy followed by radioactive iodine (RAI) therapy that approximately half of the patients with malignancy underwent after a median of 5.6 and 6.3 months relative to baseline, respectively. Subgroup analysis was not appropriate due to the limited subgroup sizes. In previous studies, RAI was related to decreased HRQoL, mostly due to physical problems. Worse HRQoL is observed with higher doses of RAI and following thyroid hormone withdrawal as compared to recombinant human thyrotropin (rhTSH) admission [526, 601, 602]. In the current study, 12 of 16 (22%) patients received RAI after thyroid hormone withdrawal for at least four weeks, the remaining after recombinant TSH administration. HRQoL was recently assessed in patients undergoing molecular testing for a Bethesda III or IV nodule using the ThyPRO (39-item version) [580, 594]. Similar to the results of the current study, patients under ultrasound surveillance following a benign molecular test result showed unchanged HRQoL from baseline to median 15 months of follow-up [580]. HRQoL scores in patients with a benign molecular test result were similar to patients with a benign cytology result, suggesting that a benign molecular test result provided similar reassurance of a low risk of malignancy [594]. Patients who underwent diagnostic surgery for a suspicious molecular test result, showed deteriorated goitre, depression and anxiety scores at the first assessment after molecular testing, all of which had improved eight months after surgery. Short-term postoperative HRQoL measurements were not available [580]. For the ThyPRO, scores range from 0 (best score) to 100 (worst score). *: p value indicates whether the between-group difference at baseline is statistically significant. †: p value indicates whether the withingroup change over time is statistically significant. §: p value indicates whether the differences in de change over time between the groups is statistically significant
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