1.Tumors Invaded in the Central Airway in Predicting Severe Immune Checkpoint Inhibitor-Related Pneumonitis Based on Propensity Score Matching
Bofeng ZHAO ; Yaming ZHANG ; Ping CHEN ; Wei FENG ; Kejun NAN ; Jinpeng LIU ; Baoying CHEN
Chinese Journal of Medical Imaging 2025;33(6):645-650
Purpose To evaluate the value of tumors invasion in the central airway(TICA)in predicting the severe immune checkpoint inhibitor-related pneumonitis(S-CIP)in lung cancer patients using propensity score matching(PSM).Materials and Methods The intact data of 162 consecutive lung cancer patients who received treatment with immune checkpoint inhibitors in Xi'an International Medical Center Hospital from September 2019 to March 2022 were retrospectively collected.Patients were divided into S-CIP group(23 cases)and non-S-CIP group(139 cases)according to the presence of S-CIP.The demographic information of the patients,including gender,age,history of smoking,thoracic radiotherapy histology,baseline lung diseases,classification,TNM stage,tumor location as well as TICA were collected.A binary Logistic regression was used to analyze the confounding factors and independent risk factors of S-CIP and to predict the development of S-CIP.A 1:1 matching was performed by the nearest neighbor method for PSM.The PSM was used to pair the two groups,and the value of TICA in predicting S-CIP before and after PSM was compared.The receiver operating characteristic curve and the area under the curve were used for model performance based on TICA.Results Before PSM,the proportion of baseline lung diseases(78.3%vs.32.4%,OR=6.802,P=0.001),thoracic radiotherapy history(69.6%vs.30.2%,OR=5.300,P=0.002)and TICA(65.2%vs.27.3%,OR=5.882,P=0.001)in the S-CIP group was higher than those in the non-S-CIP group,and were independent risk factor for predicting S-CIP.After PSM,20 patients were included in each group.The presence of TICA was higher in S-CIP group than that in the non-S-CIP group(60.0%vs.20.0%,OR=6.000,P=0.013).The area under the curves of Logistic regression model based on TICA was 0.700(95%CI 0.534-0.866).Conclusion TICA is an independent risk factor for development of S-CIP,which has moderate degree of accuracy in predicting S-CIP,can be used for risk prediction and early intervention to reduce the poor prognosis of S-CIP patients.
2.Enhanced MRI"strawberry sign"for differentiating solitary predominantly cystic brain metastasis and glioma
Bofeng ZHAO ; Wei FENG ; Xiaohan GUO ; Ping CHEN ; Xiaolong FAN ; Baoying CHEN
Chinese Journal of Medical Imaging Technology 2025;41(6):888-891
Objective To observe the value of enhanced MRI"strawberry sign"for differentiating solitary predominantly cystic brain metastasis and glioma.Methods Thirty-four patients with solitary predominantly cystic(cystic proportion greater than 50%)brain metastasis(metastasis group)and 43 with solitary predominantly cystic glioma(glioma group)were retrospectively enrolled,and the value of"strawberry sign"showed on contrast enhanced T1WI(CE-T1WI)for differentiation was analyzed.Results The detection rate of"strawberry sign"in metastasis group was 44.12%(15/34),and the primary cancer was lung adenocarcinoma in 6 cases(6/15,40.00%),small cell lung cancer in 3 cases(3/15,20.00%),as well as lung squamous cell carcinoma,breast cancer,colon adenocarcinoma,endometrioid carcinoma,fallopian tube adenocarcinoma and rectal melanoma each in 1 case(1/15,6.67%).Meanwhile,the detection rate of"strawberry sign"in glioma group was 18.60%(8/43),and all were observed in WHO grade 4 gliomas.The detection rate of"strawberry sign"in metastasis group was higher than that in glioma group,which was not related to patients' gender(P=0.442).The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of"strawberry sign"for differentiating solitary predominantly cystic brain metastasis and glioma was 44.12%,81.40%,64.94%,65.22%and 64.81%,respectively.Conclusion"Strawberry sign"showed on CE-T1WI was helpful for differentiating solitary predominantly cystic brain metastasis and glioma.
3.Tumors Invaded in the Central Airway in Predicting Severe Immune Checkpoint Inhibitor-Related Pneumonitis Based on Propensity Score Matching
Bofeng ZHAO ; Yaming ZHANG ; Ping CHEN ; Wei FENG ; Kejun NAN ; Jinpeng LIU ; Baoying CHEN
Chinese Journal of Medical Imaging 2025;33(6):645-650
Purpose To evaluate the value of tumors invasion in the central airway(TICA)in predicting the severe immune checkpoint inhibitor-related pneumonitis(S-CIP)in lung cancer patients using propensity score matching(PSM).Materials and Methods The intact data of 162 consecutive lung cancer patients who received treatment with immune checkpoint inhibitors in Xi'an International Medical Center Hospital from September 2019 to March 2022 were retrospectively collected.Patients were divided into S-CIP group(23 cases)and non-S-CIP group(139 cases)according to the presence of S-CIP.The demographic information of the patients,including gender,age,history of smoking,thoracic radiotherapy histology,baseline lung diseases,classification,TNM stage,tumor location as well as TICA were collected.A binary Logistic regression was used to analyze the confounding factors and independent risk factors of S-CIP and to predict the development of S-CIP.A 1:1 matching was performed by the nearest neighbor method for PSM.The PSM was used to pair the two groups,and the value of TICA in predicting S-CIP before and after PSM was compared.The receiver operating characteristic curve and the area under the curve were used for model performance based on TICA.Results Before PSM,the proportion of baseline lung diseases(78.3%vs.32.4%,OR=6.802,P=0.001),thoracic radiotherapy history(69.6%vs.30.2%,OR=5.300,P=0.002)and TICA(65.2%vs.27.3%,OR=5.882,P=0.001)in the S-CIP group was higher than those in the non-S-CIP group,and were independent risk factor for predicting S-CIP.After PSM,20 patients were included in each group.The presence of TICA was higher in S-CIP group than that in the non-S-CIP group(60.0%vs.20.0%,OR=6.000,P=0.013).The area under the curves of Logistic regression model based on TICA was 0.700(95%CI 0.534-0.866).Conclusion TICA is an independent risk factor for development of S-CIP,which has moderate degree of accuracy in predicting S-CIP,can be used for risk prediction and early intervention to reduce the poor prognosis of S-CIP patients.
4.Enhanced MRI"strawberry sign"for differentiating solitary predominantly cystic brain metastasis and glioma
Bofeng ZHAO ; Wei FENG ; Xiaohan GUO ; Ping CHEN ; Xiaolong FAN ; Baoying CHEN
Chinese Journal of Medical Imaging Technology 2025;41(6):888-891
Objective To observe the value of enhanced MRI"strawberry sign"for differentiating solitary predominantly cystic brain metastasis and glioma.Methods Thirty-four patients with solitary predominantly cystic(cystic proportion greater than 50%)brain metastasis(metastasis group)and 43 with solitary predominantly cystic glioma(glioma group)were retrospectively enrolled,and the value of"strawberry sign"showed on contrast enhanced T1WI(CE-T1WI)for differentiation was analyzed.Results The detection rate of"strawberry sign"in metastasis group was 44.12%(15/34),and the primary cancer was lung adenocarcinoma in 6 cases(6/15,40.00%),small cell lung cancer in 3 cases(3/15,20.00%),as well as lung squamous cell carcinoma,breast cancer,colon adenocarcinoma,endometrioid carcinoma,fallopian tube adenocarcinoma and rectal melanoma each in 1 case(1/15,6.67%).Meanwhile,the detection rate of"strawberry sign"in glioma group was 18.60%(8/43),and all were observed in WHO grade 4 gliomas.The detection rate of"strawberry sign"in metastasis group was higher than that in glioma group,which was not related to patients' gender(P=0.442).The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of"strawberry sign"for differentiating solitary predominantly cystic brain metastasis and glioma was 44.12%,81.40%,64.94%,65.22%and 64.81%,respectively.Conclusion"Strawberry sign"showed on CE-T1WI was helpful for differentiating solitary predominantly cystic brain metastasis and glioma.
5.CT Imaging Characteristics of Severe(Grade 3-4)Immune Checkpoint Inhibitor-Related Pneumonitis in Lung Cancer
Bofeng ZHAO ; Yamin ZHANG ; Ping CHEN ; Wei FENG ; Jinpeng LIU ; Kejun NAN ; Baoying CHEN
Chinese Journal of Medical Imaging 2024;32(9):903-907
Purpose To observe the clinical and CT features of severe immune checkpoint inhibitor-related pneumonitis(CIP)in lung cancer patients.Materials and Methods A total of 174 patients with lung cancer who received immune checkpoint inhibitor(PD-1/PD-L1 inhibitors)in Xi'an International Medical Center Hospital from September 1,2019 to March 31,2022 were retrospectively collected.Clinical and imaging features of patients with severe CIP were analyzed.Results There were 23 patients who met the diagnostic criteria of severe CIP.Among them,22 were male patients,15 were younger(<65 years old),17 had a history of underlying lung disease,16 had a history of chemoradiotherapy and other treatments,and 21 had a history of combined radiotherapy and chemoradiotherapy.The median time from the initiation of immune checkpoint inhibitor to CIP was 128(74,348)days.19 patients were non-small cell carcinoma.CIP occurred in 16 patients with right lung cancer,15 had tumor central airway invasion,14 had radiographic features of diffuse alveolar injury/acute interstitial pneumonia pattern,and 20 died during follow-up.Conclusion Severe CIP is likely to occur in male lung cancer patients with a history of basic medical history and radiotherapy and chemotherapy.The clinical manifestations are varied,and the main imaging features are diffuse alveolar injury/acute interstitial pneumonia pattern,and the prognosis is poor.
6.CT"cut-edge sign"for differentiating complex thymic cyst and thymic epithelial tumor with diameter less than 4 cm
Bofeng ZHAO ; Xiaohan GUO ; Ping CHEN ; Wei FENG ; Donghong WEI ; Baoying CHEN
Chinese Journal of Medical Imaging Technology 2023;39(12):1823-1826
Objective To observe the value of CT"cut-edge sign"for differentiating complex thymic cyst and thymic epithelial tumor(TET)with diameter less than 4 cm.Methods Data of 24 patients with complex thymic cyst(complex thymic cyst group)and 14 patients with TET(TET group)confirmed by surgical pathology who underwent plain and dual-phase enhanced chest CT scanning were retrospectively analyzed.CT"cut-edge sign"was evaluated by 2 physicians,and the inter-observer consistency was evaluated using intra-class correlation coefficient(ICC).The detection rate of CT"cut-edge sign"was compared between groups using logistic regression analysis.Receiver operating characteristic(ROC)curve was drawn,and the area under the curve(AUC)was calculated to evaluate the efficacy of CT"cut-edge sign"for differentiating complex thymic cyst and TET.Results The inter-observer consistency of CT"cut-edge sign"was good(ICC=0.94,95%CI[0.90,0.97]).The detection rate of CT"cut-edge sign"in complex thymic cyst group was 62.50%(15/24),higher than in TET group(2/14,14.29%)(P<0.01).The sensitivity,specificity,accuracy and AUC of CT"cut-edge sign"for differentiating complex thymic cyst and TET was 62.50%(15/24),85.71%(12/14),71.05%(27/38)and 0.74,respectively.Conclusion CT"cut-edge sign"was helpful for differentiating complex thymic cyst and TET with diameter less than 4 cm.
7.Genetic diversity analysis of forty-three insertion/deletion loci for forensic individual identification in Han Chinese from Beijing based on a novel panel.
Congying ZHAO ; Jinlong YANG ; Hui XU ; Shuyan MEI ; Yating FANG ; Qiong LAN ; Yajun DENG ; Bofeng ZHU
Journal of Zhejiang University. Science. B 2022;23(3):241-248
Due to the virtues of no stutter peaks, low rates of mutation, and short amplicon sizes, insertion/deletion (InDel) polymorphism is an indispensable tool for analyzing degraded DNA samples from crime scenes for human identifications (Wang et al., 2021). Herein, a self-developed panel of 43 InDel loci constructed previously by our group was utilized to evaluate the genetic diversities and explore the genetic background of the Han Chinese from Beijing (HCB) including 301 random healthy individuals. The lengths of amplicons at 43 InDel loci in this panel ranged from 87 to 199 bp, which indicated that the panel could be used as an effective tool to utilize highly degraded DNA samples for human identity testing. The loci in this panel were validated and performed well for forensic degraded DNA samples (Jin et al., 2021). The combined discrimination power (PD) and combined probability of exclusion (PE) values in this panel indicated that the 43 InDel loci could be used as the candidate markers in personal identification and parentage testing of HCB. In addition, population genetic relationships between the HCB and 26 reference populations from five continents based on 19 overlapped InDel loci were displayed by constructing a phylogenetic tree, principal component analysis (PCA), and population genetic structure analysis. The results illustrated that the HCB had closer genetic relationships with the Han populations from Chinese different regions.
Beijing
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China
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Forensic Genetics/methods*
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Gene Frequency
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Genetics, Population
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Humans
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INDEL Mutation
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Phylogeny
8.Value of MRI in diagnosis of benign and malignant breast lesions with cluster ring enhancement
Bei ZHANG ; Bofeng ZHAO ; Ying WANG ; Jun YU ; Ping CHEN ; Baoying CHEN
Journal of International Oncology 2021;48(9):527-531
Objective:To investigate the diagnostic value of MRI in benign and malignant breast lesions with cluster ring enhancement.Methods:The imaging signs of 68 patients with clustered ring enhancement who underwent MRI examination due to clinical palpation, ultrasound or X-ray examination for suspected malignant lesions in Tangdu Hospital of Air Force Military Medical University from October 2017 to July 2019 were retrospectively analyzed. The differences between benign and malignant lesions in the distribution pattern, T2 lipid suppression signal intensity, time-signal intensity curve (TIC), ductal dilatation, peripheral gland edema, pectoralis major edema were compared using χ2 test or Mann-Whitney U test, and the risk factors of MRI imaging signs of malignant breast lesions were analyzed using binomial logistic regression model. Results:There were 68 cluster ring enhancement lesions in 68 patients, all of which were single lesions, among which 18 cases (26.5%) were benign, and the common lesions were plasma cell mastitis (9 cases). Fifty cases (73.5%) were malignant, and the most common type was invasive breast cancer (40 cases). Imaging features of plasma cell mastitis showed cluster ring enhancement, regional distribution, slightly high signal on fat suppression T2 image, type Ⅲ TIC, with ductal dilatation, edema of peripheral glands and pectoralis major. Imaging features of invasive breast cancer showed cluster ring enhancement, regional distribution, iso-signal on fat suppression T2 image, type Ⅲ TIC, no ductal dilatation, and edema of peripheral gland and pectoralis major. There were statistically significant differences in the intensity of fat-suppression T2 signal ( Z=3.003, P=0.003) and duct dilatation ( χ2=7.174, P=0.007) between benign and malignant lesions. There were no significant differences in distribution ( χ2=5.510, P=0.313), TIC type ( χ2=3.538, P=0.133), peripheral gland edema ( χ2=0.164, P=0.686) and pectoralis major edema ( χ2<0.001, P>0.999). The analysis of binomial logistic regression model showed that fat-suppression T2 iso-signal ( OR=0.182, 95% CI: 0.036-0.914, P=0.039) and no ductal dilatation ( OR=0.198, 95% CI: 0.047-0.846, P=0.029) were the risk factors for breast malignant lesions. Conclusion:Breast cancer MRI findings of cluster ring enhancement, fat-suppression T2 iso-signal and no ductal dilatation are related risk factors for malignant breast lesions. MRI is helpful for early detection and diagnosis of breast lesions.
9.Evaluation of fMRI functional imaging in the curative effect of the acupuncture combined with traditional Chinese medicine in the treatment for patient with cerebral infarction
Bofeng ZHAO ; Yuanming HU ; Shuping CHEN
China Medical Equipment 2017;14(7):72-75
Objective: To explore the relationship between the combinative intervention therapy and clinical curative effect, through used function magnetic resonance imaging (fMRI) to observe the change of detection data for patients with cerebral infarction pre and post-intervention therapy of acupuncture combined with traditional Chinese medicine (TCM). Methods: 40 patients with cerebral infarction were divided into control group (20cases, received normal treatment)and observation group (20cases, received combinative treatment of acupuncture and TCM). Pre and post therapy, the patients of every group received evaluation about state of illness and detection of fMRI. The score of national institute of health stroke scale (NIHSS) was used to evaluate the degree of neurologic impairment, and analyze the imaging manifestations of fMRI on patients with cerebral infarction at basal ganglia who received acupuncture combined with TCM. Some cerebral functional imaging techniques, included blood oxygenation level dependent( BOLD), fMRI and diffusion tensor imaging (DTI), were used to grasp the changes of relevant functional region of brain and different brain regions connected with function region of patients with cerebral infarction before and after therapy. Results: The NIHSS score of observation group was significantly less than that of the control group (t=5.450, P<0.05), and the total efficiency of observation group (95%) was significantly higher than that of the control group (75%) (x2=4.329, P<0.05). And the differences of the activation frequency, activation volume, ADCavg values and the values of FA between the observation group and the control group were statistically significant (t=5.425, 2.760, 3.453, 5.513, P<0.05). Conclusion: Acupuncture combined with traditional Chinese medicine can efficiently improve the status of neurologic impairment for patients with cerebral infarction, and the clinical efficacy before and after treatment can preferably be observed by fMRI.
10.Application of LBL incorporated with CBL and PBL methods in anatomy study
Lu WANG ; Yuanyuan CHEN ; Jing ZHANG ; Bofeng LIU ; Lin ZHAO ; Cailian RUAN ; Xuefeng HUI
Chinese Journal of Medical Education Research 2016;15(4):375-378
Objective To explore the teaching effects of Lecture Based Learning (LBL) incorporated with Case Based Learning (CBL) and Problem Based Learning (PBL) methods in the teach-ing of anatomy.Methods 740 students of Grades 2012 and 2013 from clinical medical major were chosen as the subjects,randomly divided into experimental and control groups.LBL was conducted in the control group of 644 students,while LBL+PBL+CBL method was applied in the experimental group of 96 students.After completion of the course,all students were surveyed with the questionnaire and tested with specimen and theoretical examinations.The data was collected and analyzed with SPSS 17.0 and two sample U tests.Results The students' time of learning anatomy in the control group outside classroom teaching was (105 ± 25) minutes per week,while the students' time of learning anatomy in the experimental group was (190 ± 25) minutes per week.The difference was statistically significant (t=31.08,P=0.000).The difference of after-class total learn-ing time was also statistically significant between two groups(t=27.42,P=0.000).Percentages of satisfaction with teaching methods for control group were 87.5% and 87%,while for the experimental group 98% and 100%.Kruskal-Wallis test showed there were significant differences in experimental groups of grades 2012(x2=31.19,P=0.000) and 2013 (x2=40.35,P=0.000) compared with control group.Comparison of both groups' results of the examinations was statistically significant concerning multiple choices,essays and case analysis questions (P<0.05).Conclusion Teaching method of LBL incorporated with PBL and CBL was significantly effective than that of the sole traditional LBL method,which indicated its practice value.

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