1.Research Progress on Clinical Features of Pancreatic Damage Associated with Systemic Autoimmune Disease
Limeng SUN ; Jiuliang ZHAO ; Huadan XUE
Medical Journal of Peking Union Medical College Hospital 2026;17(1):238-246
Systemic autoimmune diseases represent a group of disorders characterized by loss of immune tolerance to self-antigens, leading to abnormal immune responses and subsequent tissue damage. Typical examples include systemic lupus erythematosus and systemic sclerosis. These conditions are marked by multi-system involvement, chronic progression, and recurrent flares. The pancreas, as a vital digestive and endocrine organ rich in glandular tissue and vascular supply, can also be affected by autoimmune processes. Pancreatic injury often indicates active and difficult-to-control disease, posing a serious threat to patient survival. Due to its relative rarity, diverse underlying mechanisms across different autoimmune diseases, and frequently nonspecific clinical presentations, pancreatic involvement is easily overlooked, resulting in delayed diagnosis and treatment.This article focuses on the clinical features and potential pathophysiological mechanisms of pancreatic injury associated with autoimmune diseases, such as systemic lupus erythematosus, systemic sclerosis, Sjögren's syndrome, and rheumatoid arthritis, aiming to enhance clinical awareness and facilitate early recognition and diagnosis of this condition.
2.Self-Supervised Multi-Organ Segmentation in Pediatric Abdominal CT Based on Vision Foundation Models
Qinghua ZHANG ; Ming LI ; Zhedian ZHOU ; Jian ZHENG ; Huadan XUE ; Qiuxia WANG ; Yu DU ; Zhen LI
Medical Journal of Peking Union Medical College Hospital 2026;17(4):954-962
To address the scarcity of annotated data for pediatric abdominal CT imaging and the insufficient generalization capability of existing models, we constructed a self-supervised pretraining architecture tailored for pediatric CT domain adaptation based on the visual foundation model DINOv3, and validated its performance in the task of pediatric abdominal multi-organ segmentation. We built a general-purpose radiological visual representation using the large-scale adult CT dataset CT-3M, and introduced a Gram-anchoring mechanism that employs a frozen adult pretrained model as a structural teacher to guide domain alignment of local topological structures on unlabeled pediatric CT data. Combined with a multi-scale feature aggregation strategy and a lightweight Primus decoder, downstream segmentation tasks were evaluated on a public pediatric CT dataset. Based on case-wise paired results, we compared the mean Dice similarity coefficient (DSC) and mean intersection over union (IoU) between our model and the baseline nnU-Net using the Wilcoxon signed-rank test, and computed the relative performance improvements. A total of 867 abdominal CT imaging cases were collected, constituting a pretraining dataset comprising 367 588 two-dimensional CT slices. On the public Pediatric-CT-SEG dataset (359 cases), our model achieved a mean DSC of (71.38±1.08)% and a mean IoU of (63.73±1.01)%, representing improvements of 3.22% and 3.59% over the baseline nnU-Net, respectively, with statistically significant differences ( The self-supervised pretraining framework proposed in this study effectively alleviates the domain shift between adult and pediatric abdominal CT images, significantly enhances segmentation accuracy for pediatric abdominal multi-organs-particularly small organs and structures with complex boundaries-and provides a reliable technical solution for intelligent pediatric imaging analysis in scenarios with limited annotated data.
3.Clinical Value of A Arterial and Portal CT-Based Deep Learning Model for the Differential Diagnosis of Benign and Malignant Pancreatic Cystic Lesions
Boyu CHEN ; Wenyi DENG ; Fuze CONG ; Huadan XUE
Medical Journal of Peking Union Medical College Hospital 2026;17(4):963-975
To develop a deep learning model based on arteriovenous dual-phase CT imaging features and evaluate its diagnostic value in differentiating benign from malignant pancreatic cystic lesions(PCLs). Preoperative contrast-enhanced CT images of patients with histopathologically confirmed PCLs at Peking Union Medical College Hospital from June 1, 2014 to May 31, 2023 were retrospectively collected. The data were randomly partitioned at the lesion level into training, validation, and test sets in a 3∶1∶1 ratio. CT images were preprocessed and regions of interest were delineated. Using postoperative pathological results as the reference standard, five deep learning models(ResNet50, DenseNet121, ResNeXt50, EfficientNet-b5, and MobileNetV2) were constructed to extract arteriovenous dual-phase CT imaging features for binary classification of PCLs. The optimal model was selected based on the area under the curve(AUC), accuracy, sensitivity, and specificity. Further comparative analyses were conducted against single-phase CT-based deep learning models, conventional radiomics models, and radiologist interpretations to comprehensively evaluate the performance of the arteriovenous dual-phase CT-based deep learning model in the differential diagnosis of PCLs. A total of 480 patients with 485 lesions(206 malignant and 279 benign) were ultimately enrolled. The training, validation, and test sets comprised 291, 97, and 97 lesions, corresponding to 288, 96, and 96 patients, respectively. In the validation set, the ResNeXt50 model based on arteriovenous dual-phase CT features achieved an AUC of 0.837(95% CI: 0.748-0.915), an accuracy of 77.32%(95% CI: 67.70%-85.21%), a sensitivity of 80.49%(95% CI: 65.13%-91.18%), and a specificity of 75.00%(95% CI: 61.63%-85.61%). In the test set, the corresponding values were 0.822(95% CI: 0.737-0.904), 73.20%(95% CI: 63.24%-81.68%), 82.93%(95% CI: 67.94%-92.85%), and 66.07%(95% CI: 52.19%-78.19%), demonstrating overall superior performance. Calibration curves indicated that the predicted probabilities of the model were generally consistent with observed outcomes, albeit with certain shortcomings in probability calibration. Decision curve analysis demonstrated that, overall, the use of this model for clinical decision-making conferred a net benefit to patients. Compared with single-phase CT-based models and conventional radiomics models, the ResNeXt50 model incorporating arteriovenous dual-phase CT features exhibited superior overall performance, and its diagnostic performance was comparable to that of radiologists, with good consistency. The deep learning model based on arteriovenous dual-phase CT imaging features demonstrates diagnostic value in differentiating benign from malignant PCLs and may serve as an adjunctive reference for preoperative clinical assessment. However, its stability and generalizability warrant further validation in larger cohorts and with external datasets.
4.Prediction of Mismatch Repair Deficiency Status in Endometrial Cancer Using Multiparametric MRI Radiomics and Deep Learning: A Multimodal Model with Preliminary Validation
Liru WANG ; Shangying YANG ; Boyu CHEN ; Fuze CONG ; Xinran LI ; Xinyu LIU ; Huadan XUE ; Zhengyu JIN ; Yang XIANG ; Yonglan HE ; Yuan LI
Medical Journal of Peking Union Medical College Hospital 2026;17(4):976-984
To explore the clinical value of a multimodal predictive model based on multiparametric magnetic resonance imaging(MRI) radiomics combined with deep learning(DL) features for the preoperative noninvasive assessment of mismatch repair-deficient(MMRd) status in endometrial cancer(EC). Patients diagnosed with EC at Peking Union Medical College Hospital from January 2015 to December 2021 were retrospectively enrolled and randomly divided into a training set and a validation set at a ratio of 8∶2. Relevant clinical data were collected, and radiomics features and DL features were extracted from preoperative contrast-enhanced T1-weighted imaging(CE-T1WI), fat-suppressed T2-weighted imaging(fs-T2WI), and diffusion-weighted imaging(DWI) sequences. High-dimensional feature selection and dimensionality reduction were performed sequentially using the recursive feature elimination(RFE) algorithm to generate a radiomics score(Rad-score) and a deep learning score(DL-score), respectively. Multivariate logistic regression was utilized to construct a clinical model, a pure radiomics model, a clinical-radiomics model, and an integrated multimodal model incorporating clinical indicators, Rad-score, and DL-score. Model performance was assessed and compared using area under receiver operating characteristic curve(AUC) and DeLong test. A total of 509 patients were enrolled in this study, comprising 413 in the training cohort and 96 in the validation cohort. Independent predictors: Multivariate analysis indicated that preoperative fasting blood glucose level, histological grade, lymph node metastasis status, Rad-score, and DL-score were all independent significant predictors of MMRd status in EC patients. The integrated multimodal model demonstrated optimal predictive performance with an AUC of 0.699(95% CI: 0.635-0.763) in the training set, which was superior to the clinical model(AUC=0.629, 95% CI: 0.561-0.697) and the pure radiomics model(AUC=0.641, 95% CI: 0.575-0.706). In the validation set, the integrated model maintained good generalizability, achieving an AUC of 0.655(95% CI: 0.535-0.775), and its diagnostic efficacy was higher than that of the clinical model(AUC=0.578, 95% CI: 0.450-0.705) and the pure radiomics model(AUC=0.611, 95% CI: 0.488-0.734). According to the DeLong test, the incorporation of DL features resulted in the clinicalradiomicsdeep learning model performing better than both the clinicalonly model( The initially developed clinical-radiomics-deep learning model exhibits a certain predictive potential for the MMRd status in patients with EC. The inclusion of DL features may help complement the limitations of traditional evaluations, offering a preliminary radiological reference for preoperative non-invasive screening. However, given the current diagnostic performance, its overall accuracy and clinical generalizability warrant further validation in multi-center, large-sample external cohort studies.
5.The value of nomogram model based on CT features in differentiating ectopic pancreatic and gastrointestinal small stromal tumors
Feng WEN ; Zhibing RUAN ; Huadan XUE ; Ting MENG ; Jinhuan QU ; Lin HUANG ; Kun CHEN ; Maoli XU ; Huilin CHEN ; Shihan SHI ; Geya TANG
Chinese Journal of Radiology 2025;59(5):565-571
Objective:To investigate the value of nomogram model based on CT features in differentiating ectopic pancreas (EP) from gastrointestinal stromal tumors (GIST) with a long diameter less than 3 cm.Methods:This study was a case-control study. The clinical and imaging data of 43 patients with EP and 90 patients with GIST confirmed by pathology in the Affiliated Hospital of Guizhou Medical University from August 2013 to March 2024 were retrospectively analyzed. Preoperative CT images were analyzed to obtain qualitative features (number of lesions, location, morphology, growth pattern, borders, cystic degeneration, calcification, ulceration, catheter sign, central umbilication) and quantitative features (lesion long diameter, short diameter, long/short diameter, lesion and normal pancreas arterial-phase and venous-phase CT values, and enhancement ratio). Statistical analyses, including independent sample t-tests, Mann-Whitney U tests, χ2 tests, and Fisher exact tests, were performed to compare CT characteristics between the two groups. Binary logistic regression analysis was used to obtain independent predictors to identify the two groups, to establish a joint model, and to draw a nomogram. The discriminative performance of the independent predictors and the combined model was assessed using receiver operating characteristic (ROC) curves, while calibration curves were used to evaluate model fit. Results:The differences in age, location, morphology, border, catheter sign, central umbilication, short diameter, long/short diameter, arteriovenous phase enhancement CT value and arteriovenous phase enhancement ratio were statistically significant between the EP group and the GIST group (all P<0.05). The logistic analysis showed that the differences in age ( OR=0.920, 95% CI 0.885-0.956, P<0.001), border ( OR=5.994, 95% CI 2.111-17.022, P=0.001), long/short diameter ( OR=7.820, 95% CI 1.841-33.224, P=0.005), and venous phase enhancement ratio ( OR=8.847, 95% CI 1.103-70.972, P=0.040) were the independent predictors for distinguishing EP from GIST, and the area under the ROC curve (AUC) were 0.782 (95% CI 0.698-0.866), 0.684 (95% CI 0.600-0.767), 0.705 (95% CI 0.607-0.803), and 0.693 (95% CI 0.605-0.781), respectively. Combined age, border, long diameter/short diameter and venous phase enhancement ratio were plotted in a nomogram with an AUC of 0.881 (95% CI 0.817-0.945), sensitivity and specificity of 74.4% and 93.3%, respectively. The calibration curve demonstrated a strong agreement between predicted and actual probabilities (Hosmer-Lemeschow test, P=0.267). Conclusions:CT imaging reveals significant differences between EP and small GISTs (<3 cm). EP is more likely when patients are younger and lesions exhibit indistinct borders, a higher long-to-short diameter ratio, and greater venous-phase enhancement. The nomogram derived from CT features provides a valuable tool for differentiating EP from GIST.
6.The value of nomogram model based on CT features in differentiating ectopic pancreatic and gastrointestinal small stromal tumors
Feng WEN ; Zhibing RUAN ; Huadan XUE ; Ting MENG ; Jinhuan QU ; Lin HUANG ; Kun CHEN ; Maoli XU ; Huilin CHEN ; Shihan SHI ; Geya TANG
Chinese Journal of Radiology 2025;59(5):565-571
Objective:To investigate the value of nomogram model based on CT features in differentiating ectopic pancreas (EP) from gastrointestinal stromal tumors (GIST) with a long diameter less than 3 cm.Methods:This study was a case-control study. The clinical and imaging data of 43 patients with EP and 90 patients with GIST confirmed by pathology in the Affiliated Hospital of Guizhou Medical University from August 2013 to March 2024 were retrospectively analyzed. Preoperative CT images were analyzed to obtain qualitative features (number of lesions, location, morphology, growth pattern, borders, cystic degeneration, calcification, ulceration, catheter sign, central umbilication) and quantitative features (lesion long diameter, short diameter, long/short diameter, lesion and normal pancreas arterial-phase and venous-phase CT values, and enhancement ratio). Statistical analyses, including independent sample t-tests, Mann-Whitney U tests, χ2 tests, and Fisher exact tests, were performed to compare CT characteristics between the two groups. Binary logistic regression analysis was used to obtain independent predictors to identify the two groups, to establish a joint model, and to draw a nomogram. The discriminative performance of the independent predictors and the combined model was assessed using receiver operating characteristic (ROC) curves, while calibration curves were used to evaluate model fit. Results:The differences in age, location, morphology, border, catheter sign, central umbilication, short diameter, long/short diameter, arteriovenous phase enhancement CT value and arteriovenous phase enhancement ratio were statistically significant between the EP group and the GIST group (all P<0.05). The logistic analysis showed that the differences in age ( OR=0.920, 95% CI 0.885-0.956, P<0.001), border ( OR=5.994, 95% CI 2.111-17.022, P=0.001), long/short diameter ( OR=7.820, 95% CI 1.841-33.224, P=0.005), and venous phase enhancement ratio ( OR=8.847, 95% CI 1.103-70.972, P=0.040) were the independent predictors for distinguishing EP from GIST, and the area under the ROC curve (AUC) were 0.782 (95% CI 0.698-0.866), 0.684 (95% CI 0.600-0.767), 0.705 (95% CI 0.607-0.803), and 0.693 (95% CI 0.605-0.781), respectively. Combined age, border, long diameter/short diameter and venous phase enhancement ratio were plotted in a nomogram with an AUC of 0.881 (95% CI 0.817-0.945), sensitivity and specificity of 74.4% and 93.3%, respectively. The calibration curve demonstrated a strong agreement between predicted and actual probabilities (Hosmer-Lemeschow test, P=0.267). Conclusions:CT imaging reveals significant differences between EP and small GISTs (<3 cm). EP is more likely when patients are younger and lesions exhibit indistinct borders, a higher long-to-short diameter ratio, and greater venous-phase enhancement. The nomogram derived from CT features provides a valuable tool for differentiating EP from GIST.
7.Establishment and Preliminary Application of Competency Model for Undergraduate Medical Imaging Teachers
Tong SU ; Yu CHEN ; Daming ZHANG ; Jun ZHAO ; Hao SUN ; Ning DING ; Huadan XUE ; Zhengyu JIN
Medical Journal of Peking Union Medical College Hospital 2024;15(3):708-717
To establish a medical imaging teacher competency model and evaluate its application value in group teaching for undergraduates. Based on literature review, a competency model for teachers in medical colleges and universities was established. This study collected the self-evaluation scores and student evaluation scores of the competency model for teachers from Radiology Department of Peking Union Medical College Hospital who participated in the undergraduate medical imaging group teaching from September 2020 to November 2021, and compared the differences of various competencies before and after training, between different professional titles and between different length of teaching. A total of 18 teachers were included in the teaching of undergraduate medical imaging group, with 11 having short teaching experience (≤5 years) and 7 having long teaching experience (> 5 years). Altogether 200 undergraduate students participated in the course (95 in the class of 2016 and 105 in the class of 2017). There were 8 teachers with a junior professional title, 5 with an intermediate professional title, and 5 with a senior professional title. The teacher competency model covered a total of 5 first-level indicators, including medical education knowledge, teaching competency, scientific research competency, organizational competency, and others, which corresponded to 13 second-level indicators. The teachers' self-evaluation scores of two first-level indicators, scientific research competency and organizational competency, as well as three second-level indicators, teaching skills, academic research on teaching and research, and communication abilities, showed significant improvements after the training, compared to those before training(all The competency model of undergraduate medical imaging teachers based on teacher competency can be preliminarily applied for the training of medical imaging teachers, as it reflects the change of competency of the teachers with different professional titles and teaching years in the process of group teaching.
8.Advances in Magnetic-Optical Multimodality Molecular Imaging for Precision Diagnosis and Treatment of Pancreatic Cancer
Medical Journal of Peking Union Medical College Hospital 2024;15(4):877-883
Pancreatic cancer, one of the most lethal cancers in the world, has been increasing in incidence and mortality year by year, and the overall prognosis of patients is poor. Early detection and effective treatment are crucial for improving the prognosis and survival rates of pancreatic cancer patients. Unlike traditional imaging, emerging molecular imaging can visualize the abnormalities at the molecular or cellular level in the process of tumor development. At present, multimodality molecular imaging that integrates multiple imaging methods to achieve complementary advantages and multifunctional nanoplatforms with integrated diagnosis and treatment functions have become research hotspots in the field of molecular imaging. Remarkable progress has been made in preclinical research concerning magnetic-optical multimodality molecular imaging probes and their derived multifunctional nanoplatforms, which provides new ideas for early detection, accurate treatment and efficacy evaluation of pancreatic cancer.
9.Establishment and validation of a predictive model for the progression of pancreatic cystic lesions based on clinical and CT radiological features
Wenyi DENG ; Feiyang XIE ; Li MAO ; Xiuli LI ; Zhaoyong SUN ; Kai XU ; Liang ZHU ; Zhengyu JIN ; Xiao LI ; Huadan XUE
Chinese Journal of Pancreatology 2024;24(1):23-28
Objective:To construct a machine-learning model for predicting the progression of pancreatic cystic lesions (PCLs) based on clinical and CT features, and to evaluate its predictive performance in internal/external testing cohorts.Methods:Baseline clinical and radiological data of 200 PCLs in 177 patients undergoing abdominal thin slice enhanced CT examination at Peking Union Medical College Hospital from July 2014 to December 2022 were retrospectively collected. PCLs were divided into progressive and non-progressive groups according to whether the signs indicated for surgery by the guidelines of the European study group on PCLs were present during three-year follow-up. 200 PCLs were randomly divided into training (150 PCLs) and internal testing cohorts (50 PCLs) at the ratio of 1∶3. 15 PCLs in 14 patients at Jinling Affiliated Hospital of Medical School of Nanjing University from October 2011 to May 2020 were enrolled as external testing cohort. The clinical and CT radiological features were recorded. Multiple feature selection methods and machine-learning models were implemented and combined to identify the optimal machine-learning model based on the 10-fold cross-validation method. Receiver operating characteristics (ROC) curve was drawn and area under curve (AUC) was calculated. The model with the highest AUC was determined as the optimal model. The optimal model's predictive performance was evaluated on testing cohort by calculating AUC, sensitivity, specificity and accuracy. Permutation importance was used to assess the importance of optimal model features. Calibration curves of the optimal model were established to evaluate the model's clinical applicability by Hosmer-Lemeshow test.Results:In training and internal testing cohorts, the progressive and non-progressive groups were significantly different on history of pancreatitis, lesions size, main pancreatic duct diameter and dilation, thick cyst wall, presence of septation and thick septation (all P value <0.05) In internal testing cohort, the two groups were significantly different on gender, lesion calcification and pancreatic atrophy (all P value <0.05). In external testing cohort, the two groups were significantly different on lesions size and pancreatic duct dilation (both P<0.05). The support vector machine (SVM) model based on five features selected by F test (lesion size, thick cyst wall, history of pancreatitis, main pancreatic duct diameter and dilation) achieved the highest AUC of 0.899 during cross-validation. SVM model for predicting the progression of PCLs demonstrated an AUC of 0.909, sensitivity of 82.4%, specificity of 72.7%, and accuracy of 76.0% in the internal testing cohort, and 0.944, 100%, 77.8%, and 86.7% in the external testing cohort. Calibration curved showed that the predicted probability by the model was comparable to the real progression of PCLs. Hosmer-Lemeshow goodness-of-fit test affirmed the model's consistency with actual PCLs progression in testing cohorts. Conclusions:The SVM model based on clinical and CT features can help doctors predict the PCLs progression within three-year follow-up, thus achieving efficient patient management and rational allocation of medical resource.
10.Applications of Artificial Intelligence in Pancreatic Cystic Lesion Imaging
Wenyi DENG ; Feiyang XIE ; Huadan XUE
Acta Academiae Medicinae Sinicae 2024;46(2):275-280
As the detection rate of pancreatic cystic lesions(PCL)increases,artificial intelligence(AI)has made breakthroughs in the imaging workflow of PCL,including image post-processing,lesion detection,segmentation,diagnosis and differential diagnosis.AI-based image post-processing can optimize the quality of medical images and AI-assisted models for lesion detection,segmentation,diagnosis and differential diagnosis significantly enhance the work efficiency of radiologists.This article reviews the application progress of AI in PCL imaging and provides prospects for future research directions.

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