Standard deviation of CT radiomic features among malignancies in each individual: prognostic ability in lung cancer patients.

PURPOSE: It was reported that individual heterogeneity among malignancies (IHAM) might correlate well to the prognosis of lung cancer; however, seldom radiomic study is on this field. Standard deviation (SD) in statistics could scale average amount of variability of a variable; therefore, we used SD of CT feature (FeatureSD) among primary tumor and malignant lymph nodes (LNs) in an individual to represent IHAM, and its prognostic ability was explored. METHODS: The enrolled patients who had accepted PET/CT scans were selected from our previous study (ClinicalTrials.gov, NCT03648151). The patients had primary tumor and at least one LN, and standardized uptake value of LN higher than 2.0 and 2.5 were enrolled as the cohort 1 (n = 94) and 2 (n = 88), respectively. FeatureSD from the combined or thin-section CT were calculated among primary tumor and malignant LNs in each patient, and were separately selected by the survival XGBoost method. Finally, their prognostic ability was compared to the significant patient characteristics identified by the Cox regression. RESULTS: In the univariate and multi-variate Cox analysis, surgery, target therapy, and TNM stage were significantly against OS in the both cohorts. In the survival XGBoost analysis of the thin-section CT dataset, none FeatureSD could be repeatably ranked on the top list of the both cohorts. For the combined CT dataset, only one FeatureSD ranked in the top three of both cohorts, but the three significant factors in the Cox regression were not even on the list. Both in the cohort 1 and 2, C-index of the model composed of the three factors could be improved by integrating the continuous FeatureSD; furthermore, that of each factor was obviously lower than FeatureSD. CONCLUSION: Standard deviation of CT features among malignant foci within an individual was a powerful prognostic factor in vivo for lung cancer patients.

Verification and evaluation of the prognostic models for extranodal natural killer / T-cell lymphoma, nasal type / 白血病·淋巴瘤

Objective To verify and evaluate the prognostic models for extranodal natural killer/T-cell lymphoma, nasal type (ENKL). Methods ENKL patients in the 105th Hospital of PLA from January 1990 to December 2015 were retrospectively analyzed, and patients were followed to the August 2016 through telephone and medical records. The models were evaluated by C-index, and the prognostic ability of each factor was assessed by survival curves. Results A total of 76 patients met the inclusion criteria, with a median age of 41.9 years old (range, 14-74 years old), all patients received chemotherapy, and 49 received radiation therapy. During the median observation time (37.0 months), 37 patients died in a median of 28.4 months. The prognostic factors of Eastern Cooperative Oncology Group performance status (ECOG PS) score, level of lactate dehydrogenase (LDH) and Ann Arbor staging were the influencing factors of overall survival in the univariate survival analysis (all P<0.05), and only ECOG PS score was significant in the multivariate Cox regression (OR: 4.231, 95 ％ CI 2.172-8.240, P= 0.000). C-index of international prognostic index (IPI) was 0.541 (95 ％ CI 0.534- 0.555), and those of model with ECOG PS score, Ann Arbor staging, primary lesion invasion, LDH and age as the indicators and model with ECOG PS core, Ann Arbor staging, primary lesion invasion, LDH and hemoglobin as the indicators were both 0.726 (95 ％ CI 0.626-0.826). Conclusion Both model with ECOG PS score, Ann Arbor staging, primary lesion invasion, LDH and age as the indicators and model with ECOG PS core, Ann Arbor staging, primary lesion invasion, LDH and hemoglobin as the indicators can accurately predict the prognosis of patients with ENKL and are significantly better than the IPI model.

Mutation analysis for a family affected with von Hippel-Lindau syndrome / 中华医学遗传学杂志

OBJECTIVE@#To detect VHL gene mutation in a pedigree affected with von Hippel-Lindau syndrome (VHL).@*METHODS@#Clinical data of the pedigree was reviewed. Patients were subjected to Sanger sequencing to detect mutation of the VHL gene. Structure of pVHL was predicted by 3D modeling using the swiss-model.@*RESULTS@#A novel c.426delT(p.V142fs) [NM_000551] mutation was found in exon 2 of the VHL gene. 3D modeling suggested that the alpha-structure of pVHL is completely absent.@*CONCLUSION@#The novel c.426delT(p.V142fs) mutation probably underlies the VHL in this pedigree.

A step-by-step regressed pediatric kidney depth formula validated by a reasonable index.

In predicting pediatric kidney depth, we are especially interested in that the errors of most estimates are within a narrow range. Therefore, this study was intended to use the proportion of estimates within a range of -5 to 5 mm (P5 mm) to evaluate the formulas and tried to regress a kidney depth formula for children. The enrolled children aged from 1 to 19 years were randomly sampled into group A and group B (75% and 25% of all recruits, respectively). Using data of the group A, the test formula was regressed by nonlinear regression and subsequently Passing & Bablok regression, and validated in group B. The Raynaud, Gordon, Tonnesen, Taylor, and the test formulas were evaluated in the 2 groups. Accuracy was evaluated by bias, absolute bias, and P5 mm; and precision was evaluated by correlation coefficient. In addition, root-mean square error was used as a mixed index for both accuracy and precision. Body weight, height, and age did not have significant differences between the 2 groups. In the nonlinear regression, coefficients of the formula (kidney depth = a × weight/height + b × age) from group A were in narrower 95% confidence intervals. After the Passing & Bablok regression, biases of left and right kidney estimates were significantly decreased. In the evaluation of formulas, the test formula was obviously better than other formulas mentioned above, and P5 mm for left and right kidneys was about 60%. Among children younger than 10 years, P5 mm was even more than 70% for left and right kidney depths. To predict pediatric kidney depth, accuracy and precision of a step-by-step regressed formula were better than the 4 "standard" formulas.

Influence of Weight-Age Normalization on Glomerular Filtration Rate Values of Renal Patients: A STROBE-Compliant Article.

To explore whether weight-age (W-A) could be applied in clinical practice, this study was designed to verify the normalization ability of W-A by the data from another medical center, and to access the influence of the normalization on glomerular filtration rate (GFR) values in renal patients.Both plasma clearance (pGFR) and camera-based (gGFR), which were separately scaled to W-A and body surface area (BSA), were measured for patients with diffuse renal diseases. The patients (n = 298) were stratified according to the Chinese body mass index (BMI) criteria and were staged according to the Kidney Disease Outcome Quality Initiatives guideline based on gGFR and pGFR separately.The indices of intraclass correlation coefficient (ICC), concordance correlation coefficient (CCC), and ratio of residual standard deviation to pooled standard deviation (RSD/PSD) suggested that, for all patients and each BMI stratum, W-A was obviously better than BSA in scaling GFR. Both under pGFR or gGFR renal stages, only small amount of the patients encountered stage migrations from BSA to W-A scaled stages. The differences between any 2 of the unscaled, BSA scaled, and W-A scaled gGFR (or pGFR) were not obviously changed. Additionally, in some strata, W-A normalization is better than BSA normalization in decreasing the median bias between pGFR and gGFR.W-A is better than BSA in scaling GFR without obvious modifying GFR values and can be applied in routine clinical practice.

Evaluation of the estimated variables for scaling glomerular filtration rate of renal patients: a repeated measures-based method.

OBJECTIVE: Using a best variable to scale glomerular filtration rate (GFR) is important for clinical practice. The variables, estimated by equations regressed from a healthy population, are usually used in scaling GFR of renal patients. However, because the predicted variables may deviate in renal patients, it is necessary to verify whether these variables can be used to reduce the variability of GFR of renal patients. This study was designed to use repeated measures analyses to identify the best variable for scaling GFR of renal patients. METHODS: Patients with non-obstructive renal diseases were enrolled in this study. The absolute GFRs of (99m)Tc-DTPA renography (gGFR) and plasma clearance (pGFR) were measured. The indices relating to between-subjects variability, such as Passing and Bablok regression, intraclass correlation coefficient (ICC) and concordance correlation coefficient (CCC) were used to identify the best variable from body surface area (BSA), extracellular fluid volume (ECV), lean body mass (LBM), total body water (TBW), body mass index (BMI), and metabolic rate (MR). RESULTS: For the scaled indices related to between-subjects variability, ICC and CCC identified the same ranking sequence (BMI < LBMB(B; Boer) < LBMJ(J; James) < TBW < ECVB(B; Bird) < ECVS(S; Silva) < BSA < MR). In the Passing and Bablok regression, the ratio of residual standard deviation to pooled standard deviation (RSD/PSD) produced the same ranking sequence as that identified by ICC and CCC. CONCLUSION: The estimated metabolic rate can explain most between-subjects variability of GFR, and seems to be the best variable for scaling GFR of renal patients.

Regressing an optimal variable to scale glomerular filtration rate: more variations in glomerular filtration rate are explained.

BACKGROUND: To compare glomerular filtration rate (GFR) among individuals, GFR is usually scaled to body surface area (BSA) based on the ratio method, which has been debated for its accuracy in recent years. Reference to the BSA as a normalization standard is the most common method currently in use but has limitations. This study was designed to a better variable to scale GFR. METHODS: We measured 99mTc- diethylene triamine pentaacetic acid plasma clearance (uncorrected GFR, uGFR) for 322 healthy adults who were enrolled according to the SENIEUR protocol. The individuals were randomly grouped into A and B for regressing and validating the optimal variable, respectively. Nonlinear regression was performed against uGFR, and the selected independent variables were body weight, height, age, and sex. RESULTS: Among several tested models, the regression coefficients of weight-age formula (W-A) were in narrower 95% confidence interval (CI). The coefficient of determination of the regression line between W-A and uGFR, as an indicator to explain the percentage of variations of GFR, was higher than that of other variables in both groups. The coefficient of determination of the regression line between W-A and uGFR was 0.571, which was higher than that of BSA (0.203) or TBW (0.241). CONCLUSION: The index variable, based on both body weight and age, has a better statistical relationship to uGFR and is a better variable to scale GFR in adults.

The variables in normalizing glomerular filtration rate / 中华核医学与分子影像杂志

Normalizing GFR with variables is important for non-cancer patients,especially for kidney donors.The most frequently evaluated variables are body surface area (BSA),extracellular fluid volume (ECV) and lean body mass (LBM).It is difficult to accurately quantify BSA and the power of BSA normalization decreases in children and obesity population.The ECV normalization is suitable for healthy children,but its clinical value decreases in patients with damaged renal function.The LBM can be accurately measured and has a larger serviceable range in the normalization.Although the influence factors of LBM should be extensively evaluated,the available data indicate that LBM is more suitable in the normalization of GFR than BSA and ECV.

The clinical value of three phase bone scans in differentiating benign from malignant bone foci / 肿瘤研究与临床

Objective To compare the results of three phase bone scans between benign and malignant lesions, and explore its clinical value. Methods Patients with pain symptom underwent three phase bone scan. Their corresponding clinical data was collected and input into SPSS software package for further evaluation. Results Forty-nine patients had 73 positive foci in the acquiring field of vascular and blood pool phase bone scans. Excluding 10 foci that suspected of bone metastasis, 37 of 63 were malignant,26 were benign lesion. On vascular, blood pool and delayed images, benign and malignant foci did not exist any significant difference (χ2 =3.341, 1.685 and 2.923, P ＞0.05). In these lesions, 33.3 % (5/15) foci had positive vascular and blood pool results in thoracic, 72.2 % (13/18) in extremity and 75.0 % (18/24) in pelvic.There were no significant difference among subgroup of chest, abdomen, limb and pelvic diseases. In addition,4 foci outside bone system were occasionally found in three phase bone scans. Conclusion Acquiring position could significantly affect the results of three phase bone scan, for example more sensitive rate can be found for limb and pelvis lesions. This method could not significantly differentiate malignant from benign lesions, but could detect soft tissue foci or the change of blood flow, and provide more information for differential diagnosis.

Status of nuclear medicine in Beijing: insights from the Beijing Quality Control Centre Survey 2005-2006.

OBJECTIVE: To evaluate the status of nuclear medicine in Beijing during 2005. METHODS: For evaluating the status, a survey was performed in September 2006 by postal questionnaires. Forty-two nuclear medicine departments in Beijing were investigated regarding staff, equipment and clinical applications. RESULTS: Up to January 2007, thirty nuclear medicine departments had responded to our survey (response rate, 71.4%). These departments employed a total of 321 staff (141 physicians, 122 technicians, seven physicists, 22 nurses and 29 other staff) and were equipped with 47 scanners (42 SPECT, three PET, two PET/CT) before September 2006. During 2005, these departments completed 88 135 scans (84 734 SPECT, 3401 PET), 462 246 radioimmunoassays and 2228 radioisotope treatment (1288 Graves' disease, 268 thyroid cancer, 166 bone metastasis, 506 other). Furthermore, eight major hospitals hired more highly qualified staff with greater experience, such as professors or associate professors, and who had more clinical applications than did non-majors. The percentage of the departments that conducted daily and monthly quality control procedures was 43.3% and 40.0%, respectively. CONCLUSION: Nuclear medicine departments in Beijing are on a considerable scale, but still have a long way to go in order to be well developed. Hospitals in Beijing should increase the number of physicists and perform QA/QC procedures more frequently.

Nuclear medicine scans in Beijing: insights from the Beijing Quality Control Centre Survey 2005-2006.

OBJECTIVE: To survey nuclear medicine scans carried out in Beijing during 2005. METHODS: Forty-two nuclear medicine departments were surveyed by using mailed questionnaires sent during September 2006. RESULTS: By the end of January 2007, 30 out of 42 hospitals had replied to our survey. The estimated annual number of SPECT procedures was 6.72 per 1000 population during 2005. Among SPECT applications, whole-body bone scans (n=23,090) were performed with the highest frequency, followed by myocardial perfusion imaging (n=19,092), and renal function imaging (n=10,287). The estimated number of myocardial perfusion scintigraphy scans was 1530 procedures per million population. The annual number of PET procedures was 0.25 per 1000 population. Most of these PET and SPECT examinations used relative monotonous radiotracers and most patients were in the age group of 40-70 years. However, for each cancer and each type of application, age distributions slightly varied. In addition, the analysis of gender distribution revealed that the number of male patients was higher than for female patients. CONCLUSION: The number of nuclear medicine scans carried out in Beijing during 2005 was considerable, with unbalanced clinical applications. Excluded myocardial perfusion scintigraphy, the frequencies of some applications were still lower than in western countries. Furthermore, most procedures used relatively monotonous radiotracers. Most patients were in the age group of 40-70 years and were male.