Purpose To study whether male sex is a risk factor for prognosis in patients with differentiated thyroid cancer after 131I treatment using the propensity score matching (PSM) method. Methods From April 2016 to October 2021, 1,948 postoperative differentiated thyroid cancer patients aged 43[interquartile range(IQR): 34, 54] years received 131I treatment were retrospectively enrolled and divided into male (n = 645) and female groups (n = 1,303). The PSM method was adopted to process all data to reduce the influence of data bias and confounding variables. The Mann-Whitney U test and χ2 test were used for data analysis. Multivariate logistic regression was used to analyze the risk factors affecting prognosis, and the receiver operating characteristic curve was used to analyze the relationship between stimulated thyroglobulin (sTg) level, 131I dose, and poor prognosis. Results Before PSM, the proportion of male patients with poor prognosis was significantly higher than that of female patients. After PSM, there was no difference in the proportion of poor prognosis between male and female groups. Multivariate logistic regression analysis showed that male sex, high T stage, N1b stage, M1 stage, high sTg level, and high 131I dose were risk factors for poor prognosis before PSM. After PSM, high T stage, M1 stage, high sTg level, and 131I dose were still risk factors but male sex was no longer a risk factor for poor prognosis. Conclusions After the reduction of selection bias by PSM, male sex was no longer a risk factor for prognosis after 131I treatment of differentiated thyroid cancer. In addition, high T stage (T3 + T4 stage), M1 stage, sTg ≥10.15 ng/ml, and 131I dose ≥260 mCi were risk factors for poor prognosis.
Purpose: To evaluate the effects of ltered back projection (FBP), ordered subset expectation maximisation (OSEM), and different lters on cadmium zinc telluride single photon emission computed tomography (CZT SPECT) cerebral blood perfusion image quality to optimise the image reconstruction method.Methods: Jaszczak phantom and patients with clinical cerebral ischemia were selected as study subjects. Under routine clinical conditions, tomographic imaging was performed on the phantom and patients with clinical cerebral ischemia. Image processing included image reconstruction using ltered back projection with Chang's attenuation correction (FBP ChangAC ) and OSEM algorithm with CT-based attenuation correction (CTAC), scatter correction (SC), resolution recovery (RR) (OSEM CTAC-SC-RR ), and the ltering method used Butterworth (Bw) and Gauss (Gs) lters. Visual and semi-quantitative parameters (integral uniformity, root mean square noise (RMS noise), and contrast and contrast-to-noise ratio (CNR)) were used to evaluate image quality to optimise image reconstruction parameters. One-way and two-way ANOVA were used to process phantom and clinical data.Results: In the tomographic images of phantom and brain imaging of patients, FBP+Bw had the best uniformity and the lowest noise level, while OSEM+Bw had the best contrast. Semi-quantitative analysis showed that the integral uniformity of FBP+Bw was signi cantly higher than that of OSEM+Bw and OSEM+Gs (p <0.05), and that the RMS noise of FBP+Bw was signi cantly lower than that of OSEM+Bw and OSEM+Gs (p <0.001). The contrast of FBP+Bw and OSEM+Bw in the cold sphere diameter ≥ 2 cm group was signi cantly higher than that of OSEM+Gs (p <0.001), while the CNR of FBP+Bw was signi cantly higher than that of OSEM+Bw and OSEM+Gs (p <0.001) ; the contrast of OSEM+Bw cold sphere diameter < 2 cm was signi cantly higher than that of FBP+Bw (p <0.01). The semi-quantitative analysis results of the patient's cerebral perfusion tomography were consistent with the model. Conclusion:In CZT SPECT cerebral blood ow perfusion imaging, images with lesion sizes greater than 2 cm were suitable for FBP+Bw (fc=0.40, n=10), and the image with lesion size less than 2 cm was suitable for OSEM+Bw (EM=60, fc=0.45, n=10). The reconstruction method of OSEM+Gs (EM=80, full width at half maximum [FWHM]=3.25) was not suitable for cerebral blood perfusion imaging.
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