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Analysis and interpretation of the 2022 Global Cancer Statistics Report： cancer burden and epidemiological trends in China and the world WU Qi, FAN Bonan, LI Yan Journal of Diagnostics Concepts & Practice    2025, 24 (02): 135-145.   DOI: 10.16150/j.1671-2870.2025.02.004 Abstract （1651）   HTML （64）    PDF（pc） （1203KB）（1373）       Knowledge map    Save In February 2024, the International Agency for Research on Cancer (IARC) released the 2022 Global Cancer Statistics Report. In 2022, there were nearly 20 million new cancer cases and 9.7 million deaths. The report provides statistics on the incidence and mortality of 36 different types of cancer in 185 countries around the world, analyzing geographic, gender-based, and Human Development Index (HDI)-related differences. It also predicts the global burden of cancer disease by 2050. Demographic forecasts suggest that by 2050, the number of new cancer cases worldwide is expected to reach 35 million annually-an increase of 77% compared to 2022. Geographically, cancer incidence and mortality rates show significant regional disparities. In 2022, nearly half (49.2%) of the world's new cases and the majority (56.1%) of cancer deaths occurred in Asia. In terms of gender distribution, the overall cancer incidence and mortality rate among females were lower than those among males in 2022. With respect to HDI, the risk of developing cancer increases with higher HDI levels. In 2022, the top 5 newly diagnosed cancer cases worldwide are lung cancer, female breast cancer cancer, colorectal cancer, prostate cancer, gastric cancer in turn. There were nearly 2.5 million new lung cancer cases and over 1.8 million related deaths. Breast cancer in women accounted for 2.3 million new cases and nearly 670 000 deaths. Colorectal cancer, including anal cancer, had more than 1.9 million new cases and over 900 000 deaths. Prostate cancer recorded 1.5 million new cases and nearly 400 000 deaths. There were nearly 970 000 newly-diagnosed cases of gastric cancer and 660 000 related deaths. In China in 2022, lung cancer still ranks first in the cancer incidence spectrum in China, accounting for 22.0% of the total new cases of cancer in China. This proportion has further increased compared to 2018 data (17.9%), followed by colorectal cancer (10.7%), thyroid cancer (9.7%), liver cancer (7.6%), and gastric cancer (7.4%), which account for more than half of the total new cases in China (57.4%). This paper reviews the data sources and statistical methods used in the report, interprets the epidemiological trends of major cancer types, and analyzes the incidence and burden of major cancers prevalent in China, provi-ding an overview of their disease burden and epidemiological trends. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Analysis of global trends and current status of diagnosis and treatment of inflammatory bowel diseas YANG Cuiping, CHEN Ping Journal of Diagnostics Concepts & Practice    2025, 24 (04): 373-382.   DOI: 10.16150/j.1671-2870.2025.04.003 Abstract （1210）   HTML （73）    PDF（pc） （571KB）（487）       Knowledge map    Save Inflammatory bowel disease (IBD) is a group of chronic, recurrent, nonspecific inflammatory intestinal disorders of unknown etiology, primarily comprising ulcerative colitis (UC) and Crohn's disease (CD). Over the past 30 years, IBD has transitioned from a traditional "Western disease" to a truly global disease. The prevalence of IBD in North America and Europe has stabilized at 0.5%-1.0%, while newly industrialized countries in Asia, Latin America, and Africa are experiencing a 5 to 10-fold surge in IBD incidence. It is projected that the total number of IBD patients in Asia will exceed 4 million by 2035. From 1990 to 2019, the number of IBD patients in China increased from 133 000 to 484 000 in males and from 107 000 to 427 000 in females. The age-standardized incidence of IBD in Chinese males and females increased from 1.72/100 000 and 1.20/100 000 to 3.35/100 000 and 2.65/100 000, respectively. By 2030, the number of IBD patients in China is projected to exceed 1 million. In terms of diagnosis, magnetic resonance enterography (MRE), computed tomography enterography (CTE), and video capsule endoscopy (VCE) have significantly improved the visualization of small bowel lesions. Fecal calprotectin (FC) (optimal threshold of 152 μg/g) can predict relapse, with a sensitivity of 72% and a specificity of 74%. Anti-neutrophil cytoplasmic antibody (ANCA) and anti-saccharomyces cerevisiae antibody (ASCA) can also provide a non-invasive basis for differentiating UC and CD. The multidisciplinary team (MDT) model has improved the diagnosis rate of difficult cases by 20%. In the field of treatment, conventional therapies including 5-aminosalicylic acid, corticosteroids, and immunomodulators remain the foundation. However, biologics and small molecule targeted drugs such as anti-tumor necrosis factor-α agents, anti-interleukin (IL)-12/23 agents, and Janus kinase inhibitors have become the core treatments for patients with moderate to severe IBD, achieving induction remission rates of 50%-70%. Endoscopic dilation, endoscopic mucosal resection, endoscopic submucosal dissection, or laparoscopic surgery combined with enhanced recovery after surgery can significantly reduce trauma. Exclusive enteral nutrition and probiotic interventions can achieve a remission rate of 60%-70% in pediatric CD patients. However, the accessibility of biologics in primary hospitals in China is less than 30%, and the implementation rate of enhanced recovery after surgery is below 40%, indica-ting a significant gap compared with Europe and America. In the future, a national IBD registry system should be established, and research on early diagnostic models based on artificial intelligence (AI) and pharmacoeconomics should be conducted to achieve precise prevention and treatment of IBD and alleviate the societal burden of the disease. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Interpretation of Chinese Guidelines for the Prevention and Management of Bronchial Asthma （2024 Edition） ZHOU Yan, ZHANG Min Journal of Diagnostics Concepts & Practice    2025, 24 (04): 415-422.   DOI: 10.16150/j.1671-2870.2025.04.008 Abstract （1155）   HTML （34）    PDF（pc） （509KB）（586）       Knowledge map    Save According to the Global Burden of Disease (GBD) data for 2021, the global age-standardized prevalence of asthma is 3 340.1/100 000, with a total of about 260 million patients, a mortality rate of 5.2/100 000, and 436 000 deaths. A 2012-2015 survey conducted in China shows that the prevalence of wheezing-related asthma among people aged 20 and above is 4.2%, with a total of about 45.7 million patients. However, the diagnosis rate is only 28.8%, and the control rate is only 28.5%, far below the international level, highlighting the urgent need for better asthma management and intervention. In March 2024, the Chinese Thoracic Society (CTS) released the Guidelines for the Prevention and Management of Bronchial Asthma (2024 Edition) (hereinafter referred to as the "2024 Guidelines"). For diagnostic pathways, the 2024 Guidelines improve the diagnostic criteria for asthma, emphasizing the evidence for variable expiratory airflow (such as bronchodilator tests, provocation tests, etc.). A "presumptive diagnosis pathway" is proposed for primary care and resource-limited medical institutions to improve the diagnosis rate and avoid overtreatment. In terms of staging and classification, the concept of "clinical remission" is introduced, defined as being asymptomatic for ≥1 year without the need for systemic glucocorticoid therapy. The classification of "intermittent state" is eliminated, and asthma severity is now simplified into three levels—mild, moderate and severe—with a dynamic assessment model proposed. The assessment system newly includes a type 2 inflammatory phenotype assessment, recommending the measurement of biomarkers such as peripheral blood eosinophil count (EOS) and fractional exhaled nitric oxide (FeNO) to guide individualized treatment, while also emphasizing comorbidity screening and risk factor assessment. In terms of treatment strategies, a stepwise management approach is used for chronic persistent treatment, with inhaled corticosteroid (ICS)-formoterol recommended as the preferred reliever (Pathway 1) to reduce the risk of acute exacerbations. The management of severe asthma emphasizes the use of biological targeted drugs, such as anti-IgE and anti-interleukin (IL)-5 monoclonal antibodies, while the treatment of acute exacerbations is recommended based on the severity level. Despite the significant progress made in the 2024 Guidelines, challenges remain. Epidemiological data on asthma in China are outdated, highlighting the urgent need for nationwide surveys to reflect the latest disease burden. Diagnosis rates in primary care are low, and inflammation assessment and dynamic mana-gement are insufficient, requiring strengthened capacity building at the primary care level. Real-world data on biologics in China are limited, restricting their application in precision therapy. The application of information technology in asthma management is still at an exploratory stage, and technologies like 5G should be leveraged to enhance patient education and follow-up efficiency. In the future, asthma prevention and treatment in China need to further optimize strategies for early diagnosis and early treatment, dynamically identify inflammatory phenotypes, establish drug response prediction models, and promote AI-assisted diagnosis and treatment to achieve more precise management. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Interpretation of global stroke report data in 2025： gradient evolution and precise management of stroke burden TANG Chunhua, GUO Lu, ZHANG Lili Journal of Diagnostics Concepts & Practice    2025, 24 (05): 485-497.   DOI: 10.16150/j.1671-2870.2025.05.003 Abstract （905）   HTML （31）    PDF（pc） （777KB）（316）       Knowledge map    Save In 2021, there were 93.816 million prevalent cases of stroke worldwide [age-standardized prevalence rate(ASPR) 1 099/100 000], with 11.946 million new cases in that year [age-standardized incidence rate(ASIR) 142/100 000]. Among these new cases, ischemic stroke (IS), intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH) accounted for 65.3% (7.804 million), 28.8% (3.444 million), and 5.8% (0.697 million), respectively. In the same year, stroke caused 7.253 million deaths, accounting for 10.7% of all global deaths. Deaths caused by IS, ICH, and SAH accounted for 49.5% (3.591 million), 45.6% (3.308 million), and 4.9% (353 000), respectively. In 2021, stroke remained the second leading cause of death worldwide, with its core disease burden indicator — disability-adjusted life years (DALYs) — exceeding 160 million, ranking third among all global total disease burdens. In terms of economic burden, the global direct medical costs and productivity losses caused by stroke reached 890 billion USD in 2021 (accounting for 0.66% of the global GDP), and are projected to exceed 1.8 trillion USD by 2050 if the current growth rate persists. The global stroke burden exhibits a dual trend of "increasing absolute numbers but decreasing age-standardized rates". Low- and middle-income countries bear most of the disease burden, and the incidence of stroke shows a coexistence of younger and older onset. In terms of risk factors, the burden of traditional behavior-related risks has decreased, while the attributable burden of metabolic and climate-related risks is rapidly increasing. China bears the heaviest stroke burden globally, characterized by a “four-high” pattern of “high incidence, high prevalence, medium-to-high mortality, and medium-to-high DALYs”, with significant urban-rural and regional disparities. This condition results from the combined effects of accelerated population aging and continuously increasing exposure to risk factors. In 2021, there were 26.335 million prevalent cases in China, with ASPR of 1 301.4/100 000. In 2021, there were 4.09 million new stroke cases in China (ASIR 204.8/100 000), accounting for 34.2% of all new global cases—far exceeding China's proportion of the world's population (about 20%). IS accounted for 67.8% [2.772 million cases, age-standardized incidence rate (ASIR) 135.8/100 000], and ICH accounted for 28.7% (1.173 million cases, ASIR 61.2/100 000). The annual total economic burden of stroke in China has exceeded 400 billion RMB, with its proportion in the national healthcare expenditure continuing to increase. Direct medical costs account for about 60%, while indirect costs (including productivity losses and caregiving expenses) account for 40%, imposing a dual pressure on both society and families. To address this challenge, a stratified precision prevention and control system centered on the coordination of "policy-healthcare-society" should be established, covering primordial, primary, and secondary prevention levels. Emphasis should be placed on cross-sector collaboration, data-driven approaches, and international experience sharing to achieve effective control of the stroke burden and promote global health equity. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Evolution of diagnosis standards for diabetes in China and blood glucose management for special populations ZOU Huimin, WANG Suijun Journal of Diagnostics Concepts & Practice    2025, 24 (01): 14-20.   DOI: 10.16150/j.1671-2870.2025.01.003 Abstract （549）   HTML （18）    PDF（pc） （491KB）（233）       Knowledge map    Save The prevalence of diabetes in China has been increasing annually. In 2021, the prevalence rate of diabetes reached 13.79% among individuals aged 20–79, with an undiagnosed rate as high as 56.0%. This indicates that China's diabetes prevention and control faces significant challenges. Diabetes is a chronic metabolic disease. Poor blood glucose control increases the risk of serious complications such as cardiovascular disease, kidney disease, retinopathy, and neuropathy, which impose a heavy burden on both individual health and socioeconomic development. Early detection of diabetes and the implementation of effective interventions are crucial for preventing complications. Currently, China's diabetes diagnosis primarily adopts international standards, using the 75g oral glucose tolerance test (OGTT) and glycated hemoglobin (HbA1c) as the gold standards for diagnosis. However, due to disparities in detection technologies and other factors, these methods still have certain limitations in clinical practice, especially in primary medical institutions where diabetes screening capacity and standardization level require further improvement. In addition, China demonstrates relatively low levels of awareness, treatment, and control rates of diabetes. According to 2021 data, the awareness rate of diabetes in China was 36.5%, the treatment rate was 33.2%, and the control rate was 49.2%. Although China has made some progress in diabetes prevention and treatment in recent years, there is still significant room for improvement. To address the challenges of diabetes prevention and treatment, a series of diabetes guidelines and consensus statements have been released by domestic experts, emphasizing the individualized and stratified management of diabetes patients. Different blood glucose control targets and treatment plans have been formulated for children and adolescents, pregnant women, and elderly patients. Meanwhile, the promotion of glucose monitoring technologies is considered an important approach to improve the rate of achieving blood glucose control targets. However, clinical attention remains inadequate for type 2 diabetes in children and adolescents, gestational diabetes, and elderly diabetes with sarcopenia, lacking standardized treatment strategies and high-quality medical evidence. For the current state of diabetes diagnosis and treatment in China, it remains imperative to further improve the diagnostic testing level, the coverage of examinations, and the ability of stratified management for different population groups. Reference | Related Articles | Metrics | Comments（0）

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Current situation and challenges of prevention and control of diabetes in China NING Guang Journal of Diagnostics Concepts & Practice    2025, 24 (01): 1-6.   DOI: 10.16150/j.1671-2870.2025.01.001 Abstract （530）   HTML （28）    PDF（pc） （1079KB）（147）       Knowledge map    Save Diabetes has become a major global public health issue. As of 2021， China had approximately 141 million diabetic patients， with 2/3 remaining undiagnosed， making China the country with the highest number of diabetes globally. This current status poses severe challenges to the prevention and control of diabetes and its complications. To effectively address these challenges， strategies must be comprehensive and involve multi-sectoral collaboration， including nationwide primary prevention， primary prevention for high-risk groups， and secondary prevention for diabetic patients. For the general population， it is critical to promote healthy lifestyles through health education， policy guidance， and technical resource support. For high-risk groups， emphasis should be placed on the importance of diabetes screening， coupled with combined measures of lifestyle interventions and pharmacological treatments. For diabetic patients， the focus should be on the monitoring and management of pan-risk factors associated with cardiovascular complications. China has introduced a new model for diabetes management—the National Metabolic Management Center （MMC）. By providing structured training and education for physicians within its network， the MMC promotes standardized， one-stop management solutions for diabetes， reducing regional disparities in diabetes management and effectively improving the diagnosis and treatment efficiency of diabetes and its complications. To achieve the goals of the "Healthy China 2030" initiative， concerted efforts from governments， sectors， communities， and individuals are required to raise diabetes awareness， expand standardized management coverage， and improve treatment and control rates， while reducing the incidence of diabetes and its complications. These efforts will lay a solid foundation for improving public health and building a healthy China for all. Reference | Related Articles | Metrics | Comments（0）

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Interpretation of key points in 2025 KDIGO Clinical Practice Guideline for the Evaluation，Management，and Treatment of Autosomal Dominant Polycystic Kidney Disease WU Shuangcheng, YU Shengqiang Journal of Diagnostics Concepts & Practice    2025, 24 (03): 255-262.   DOI: 10.16150/j.1671-2870.2025.03.003 Abstract （458）   HTML （17）    PDF（pc） （1343KB）（820）       Knowledge map    Save Autosomal dominant polycystic kidney disease (ADPKD) is one of the most common hereditary renal cystic disorders and a major cause of end-stage renal disease requiring renal replacement therapy. In February 2025, Kidney Disease: Improving Global Outcomes (KDIGO) released the first clinical practice guideline specifically for ADPKD entitled "KDIGO Clinical Practice Guideline for the Evaluation, Management, and Treatment of Autosomal Dominant Polycystic Kidney Disease". The guideline comprises 10 chapters covering nomenclature, diagnosis, prognosis, and prevalence of ADPKD; renal manifestations; management and progression of chronic kidney disease, renal failure, and renal replacement therapy; treatments to delay renal disease progression; polycystic liver disease; intracranial aneurysms and other extrarenal manifestations; lifestyle and psychosocial considerations; pregnancy and reproductive problems; pediatric problems; and approaches to ADPKD patient management. It highlights early diagnosis, risk stratification, integrated management, and application of the new drug tolvaptan. Additionally, the guideline introduces a new nomenclature system based on pathogenic genes for the first time, along with more stringent blood pressure management plans. By integrating guideline highlights, evidence-based medicine, and China's clinical practice, this study interprets two key clinical issues in the updated guideline: "early diagnosis and risk stratification of ADPKD" and "treatment and daily management of kidney-related symptoms." A thorough analysis of the guideline's implications and limitations is conducted, aiming to promote standardized diagnosis and therapy for ADPKD. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Advances in application of photon-counting CT for pancreatic imaging HUANG Ruikun, YANG Yanzhao, CHAI Weimin Journal of Diagnostics Concepts & Practice    2025, 24 (02): 111-117.   DOI: 10.16150/j.1671-2870.2025.02.001 Abstract （416）   HTML （50）    PDF（pc） （868KB）（343）       Knowledge map    Save Photon-counting computed tomography (PCCT) is an advanced CT imaging technology based on novel photon-counting detectors. Compared to traditional energy-integrating detector CT (EID-CT), PCCT demonstrates significant advantages in radiation dose utilization efficiency, image spatial resolution, and spectral resolution, and is expected to revolutionize imaging diagnostic paradigms for pancreatic diseases. This study systematically reviews the latest research advances in PCCT for pancreatic imaging, with a focus on its clinical application value in displaying fine pancreatic anatomical structures, visualizing the pancreas, surrounding vascular networks, and pancreaticobiliary systems, evaluating benign and malignant lesions, and quantitatively assessing tumor heterogeneity. The core technical principles of PCCT include physical characteristics such as high photon-flux processing by photon-counting detectors, K-edge imaging, and multi-energy threshold data acquisition modes. On this basis, this study summarizes optimization strategies for pancreatic imaging, including scan parameter settings and the clinical application of multimodal post-processing techniques. PCCT can effectively reduce radiation dose while overcoming the spatial resolution bottleneck, thereby improving the detection rate of cystic lesions. The low-energy monoenergetic reconstruction mode of PCCT can enhance the contrast of solid tumors and optimize the visualization of branching and tumor-feeding vessels. By integrating representative clinical studies and preliminary validation trials in recent years, this study further analyzes key challenges and corresponding strategies during the clinical translation of PCCT. Additionally, it explores the future directions of this technology in the precise diagnosis of pancreatic diseases, personalized treatment decision support, and the development of AI-big data models, aiming to provide a theoretical foundation and practical reference for promoting PCCT applications in the field of pancreatic imaging. Reference | Related Articles | Metrics | Comments（0）

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Application of photon-counting CT in cardiovascular diseases WANG Mengzhen, BAO Shouyu, LIU Peng, YAN Fuhua, YANG Wenjie Journal of Diagnostics Concepts & Practice    2025, 24 (02): 125-134.   DOI: 10.16150/j.1671-2870.2025.02.003 Abstract （397）   HTML （5）    PDF（pc） （983KB）（338）       Knowledge map    Save Photon-counting computed tomography （PCCT） is a revolutionary technological breakthrough in CT imaging over the past decade. Compared with traditional energy-integrating detector CT, PCCT performs imaging at the single-photon level at the detector layer, offering higher spatial resolution, fewer artifacts, and more accurate spectral imaging. PCCT shows great application potential in the diagnosis of cardiovascular diseases, especially in reducing beam-hardening artifacts and achieving ultra-high spatial resolution, which can further improve the specifi-city and positive predictive value in the assessment of coronary artery stenosis. This also contributes to the accurate evaluation of in-stent restenosis， reliable identification of plaque components, and characterization of vulnerable plaques. PCCT can obtain stable calcium scoring at low radiation doses. The virtual non-contrast （VNC） algorithm supports reliable calcium scoring from contrast-enhanced images, further reducing the radiation dose. PCCT can improve the reproducibility of features in pericoronary fat radiomics analysis. The VNC algorithm can accurately assess epicardial fat volume and significantly reduce radiation dose. Spectral images acquired by PCCT at high temporal resolution enable single-phase measurement of myocardial extracellular volume. They can also provide multidimensional anatomical information and functional parameters for preoperative planning and postoperative follow-up of transcatheter aortic valve implantation/replacement （TAVI/TAVR）. Although PCCT holds great potential in the diagnosis of coronary artery disease and quantitative analysis of myocardial tissues, its quantitative results remain affected by reconstruction parameters such as convolution kernels, virtual monoenergetic levels, and iterative strength. Currently, a lack of unified standards and validation from multicenter studies, along with the increased radiation dose in ultra-high-resolution modes, still limits its wide clinical application. Future studies should focus on large-sample, multicenter prospective studies to optimize imaging parameters, standardize post-processing workflows, and integrate artificial intelligence tools to enhance the clinical application of PCCT in cardiovascular disease diagnosis. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical applications of photon-counting CT in neuroimaging LÜ Haiying, LU Yong, HE Naying Journal of Diagnostics Concepts & Practice    2025, 24 (02): 212-219.   DOI: 10.16150/j.1671-2870.2025.02.013 Abstract （364）   HTML （11）    PDF（pc） （1921KB）（267）       Knowledge map    Save Photon-counting computed tomography (PCCT) is a next-generation CT imaging technology that markedly improves image quality while reducing radiation dose and image noise through single-photon detection and energy discrimination by photon detectors. At present, PCCT holds broad clinical application prospects in the field of neuroimaging, especially demonstrating unique advantages in the visualization of fine intracranial structures, the diagnosis and treatment monitoring of intracranial aneurysms, and the diagnosis and treatment of intracranial artery stenosis and spinal vascular lesions. In ultra-high-resolution (UHR) mode (slice thickness of 0.2 mm), PCCT of the head and neck arteries achieves high signal-to-noise ratios using BV64-BV72 convolution kernel reconstruction. With the digital subtraction angiography (DSA) as the gold standard, UHR-PCCTA shows sensitivity, specificity, accuracy, and inter-rater agreement of approximately 98.0%, 96.7%, 97.3%, and 0.95 (Kappa values), respectively, in diagnosing small intracranial aneurysms. In addition, UHR-PCCT significantly outperforms conventional energy-integrating detector CT (EID-CT) in identifying aneurysm irregularity, aneurysm wall, and intraluminal features. UHR-PCCT is expected to enable precise evaluation of the degree of arterial stenosis, potentially approaching the accuracy of DSA. With its multi-energy virtual monoenergetic reconstructions, it shows promise for quantitative analysis of intracranial athe-rosclerotic plaques and prediction of plaque rupture risk. Under sharp reconstruction kernels (e.g., BV72-BV80), PCCT enables clear visualization of intracranial arterial stents and residual aneurysms, offering a new noninvasive alternative to DSA for postope-rative monitoring of intracranial artery treatments. The diversified applications of PCCT in neuroimaging will lay a foundation for its better role in the diagnosis and treatment of neurological diseases. However, the widespread application of PCCT in the neurological field remains limited by factors such as restricted equipment availability, the need for imaging optimization in specific scenarios (e.g., small perforating arteries, severe calcifications, or metallic implants), and the lack of support from large-scale clinical validation data. In the future, it is necessary to gradually overcome these limitations through continued hardware upgrades, algorithmic optimization, and the advancement of multicenter prospective studies to fully unleash the clinical potential of PCCT. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Photon-counting CT in liver disease： applications and advances LI Weixia, YAN Fuhua Journal of Diagnostics Concepts & Practice    2025, 24 (02): 118-124.   DOI: 10.16150/j.1671-2870.2025.02.002 Abstract （335）   HTML （17）    PDF（pc） （543KB）（309）       Knowledge map    Save Photon-counting computed tomography (PCCT) represents a significant technological breakthrough in the field of CT imaging in recent years. This innovative technology utilizes novel semiconductor detectors to directly detect and count individual X-ray photons, enabling high-precision multi-energy data acquisition. Compared with traditional energy-integrating detector CT (EID-CT), PCCT offers significant technical advantages, including ultra-high spatial resolution (with a minimum detector pixel size of 0.15×0.18 mm), improved contrast-to-noise ratio (CNR increase of 15%-45%), and substantial radiation dose reduction (20%-90%). Moreover, PCCT can generate standardized CT value images, ensu-ring stable and reproducible quantitative measurements suitable for tissue composition analysis. With its ability to acquire data across multiple energy bins, PCCT achieves true multi-energy spectral imaging. In liver diseases, PCCT enables non-enhanced quantification of hepatic fat and iron content, with 70 keV standardized CT values showing a strong correlation with MRI-derived proton density fat fraction (PDFF). During contrast-enhanced scans, PCCT significantly improves the detection rate and lesion margin delineation of hypovascular tumors and allows accurate enhancement quantification through iodine maps. Additionally, PCCT enables ultra-low-dose, one-stop imaging that simultaneously provides functional hemodynamic parameters of hepatic microcirculation and high-quality multiphasic monoenergetic CT images for clinical diagnosis and preoperative planning—without the need for additional contrast medium or supplementary triphasic scans. This dual benefit of low radiation and contrast dose supports its clinical utility in liver imaging. This review focuses on recent advances in the application of PCCT in the diagnosis and treatment of diffuse and neoplastic liver diseases, aiming to provide theoretical foundations and practical insights for its broader implementation in precision hepatology. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Current applications and prospects of visceral fat in obesity diagnosis and comorbidity prediction ZHANG Yifei, SHI Juan, XU Yuening Journal of Diagnostics Concepts & Practice    2025, 24 (01): 7-13.   DOI: 10.16150/j.1671-2870.2025.01.002 Abstract （281）   HTML （20）    PDF（pc） （484KB）（77）       Knowledge map    Save In 2021, 2.11 billion adults aged 25 and older worldwide were overweight or obese, with China having the highest number at 402 million. By 2050, the global population of overweight or obese adults is projected to rise to 3.8 billion, with China expected to account for 627 million of this total. Moreover, obesity is strongly associated with the occurrence and progression of various diseases, including cardiovascular diseases, cancers, and type 2 diabetes. Thus, the diagnosis and management of obesity have become a major global health challenge. However, traditional body mass index (BMI)-based diagnostic systems exhibit limitations in accurately reflecting abnormal fat distribution and metabolic dysfunction. Excessive visceral fat accumulation has been identified as a key factor in obesity-related metabolic disorders. Notably, visceral fat area (VFA), as an objective and quantifiable indicator for obesity assessment, demonstrates significant correlations with obesity and its comorbidities. Recent studies show that VFA outperforms BMI in the diagnosis and prediction of obesity and its associated comorbidities. Furthermore, VFA demonstrates superior value in evaluating the therapeutic efficacy of different interventions for obesity. Experience from China's Metabolic Management Center (MMC) has demonstrated the clinical value of VFA measured by standardized bioelectrical impedance analysis in obesity diagnosis and clinical mana-gement. In the future, the diagnosis and clinical management of obesity and its comorbidities should integrate multiple assessment methods incorporating multidimensional stratification analysis and personalized precision evaluation to further enhance comprehensive clinical management of obesity. Reference | Related Articles | Metrics | Comments（0）

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Ultrasound viscoelastic imaging in differentiation of benign and malignant breast tumors QIN Yu, LI Cheng, HUA Qing, ZHANG Huiting, JIA Wanru, DONG Yijie, ZHOU Jianqiao, XIA Shujun Journal of Diagnostics Concepts & Practice    2025, 24 (02): 194-203.   DOI: 10.16150/j.1671-2870.2025.02.011 Abstract （274）   HTML （7）    PDF（pc） （1242KB）（172）       Knowledge map    Save Objective To evaluate the application value of ultrasonic viscoelastic imaging technology in differentia-ting benign and malignant breast tumors. Methods A total of 717 patients with breast tumors confirmed by surgical patho-logy were consecutively enrolled at Ruijin Hospital, Shanghai Jiao Tong University School of Medicine between February 2023 and August 2023, including 471 malignant and 246 benign cases. All patients underwent breast ultrasound examinations before treatment, including grayscale ultrasound, ultrasound strain elastography, ultrasound shear wave elastography, and ultrasound viscoelastic imaging. Ultrasound viscoelastic imaging technology included measuring four sets of parameters of the tumor and its surrounding tissues: viscosity coefficient, dispersion coefficient, shear wave elastic modulus, and strain ratio. Using the optimal predictive indicators from the four parameter groups, multiple prediction models were established, including single-variable models (viscosity coefficient, dispersion coefficient, shear wave, strain), a combined viscoelastic model (Shell/T-Vmean + Shell/T-Dmean), a Breast Imaging Reporting and Data System (BI-RADS) model, and a combined model integrating BI-RADS with viscoelastic parameters. The effectiveness of each model in differentiating benign and malignant breast tumors was evaluated. Results Parameters including viscosity coefficient, dispersion coefficient, elastic modulus, and strain ratio from ultrasound viscoelastic imaging could effectively distinguish benign and malignant breast tumors. Among them, the ratios of the tumor margin (2 mm region) to the tumor itself—Shell/T-Vmean, Shell/T-Dmean, Shell/T-Emean, and Strain Ratio A—were optimal predictive indicators, with areas under the curve (AUCs) of 0.742, 0.745, 0.726, and 0.705, respectively. The BI-RADS model for predicting benign and malignant breast tumors achieved an AUC of 0.822. When Shell/T-Vmean and Shell/T-Dmean were respectively combined with BI-RADS classification, the receiver operating characteristic (ROC) curve's AUC reached 0.895 (95% CI: 0.868–0.917), which was higher than that of BI-RADS alone. Conclusion Among the viscoelastic parameters of ultrasound viscoelastic imaging, the average ratios of viscosity coefficient, dispersion coefficient, and elastic modulus between the 2 mm tumor margin region and the tumor body are key diagnostic indicators. The combination of Shell/T-Vmean and Shell/T-Dmean with BI-RADS provides a new stra-tegy for noninvasive preoperative precision diagnosis. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Study on consistency between liver fat fraction quantification based on photon-counting CT and MRI proton density fat fraction CAI Xinxin, DENG Rong, XU Xinxin, XU Zhihan, CHANG Rui, DONG Haipeng, LIN Huimin, YAN Fuhua Journal of Diagnostics Concepts & Practice    2025, 24 (02): 146-154.   DOI: 10.16150/j.1671-2870.2025.02.005 Abstract （266）   HTML （2）    PDF（pc） （1983KB）（93）       Knowledge map    Save Objective To investigate the consistency between CT-derived fat fraction (CT-FF) based on photoncounting CT material decomposition under different scanning conditions and magnetic resonance imaging proton density fat fraction (MRI-PDFF), thereby developing a CT-based method for liver fat quantification suitable for the Chinese population. Methods From September 2023 to February 2024, a total of 383 healthy volunteers were prospectively recruited at Ruijin Hospital, Shanghai Jiao Tong University School of Medicine (176 with MRI-PDFF < 5% and 207 with MRI-PDFF≥ 5%), and randomly assigned to four photon-counting CT scanning groups based on tube voltage (120 kVp/140 kVp) and radiation dose (standard dose/low dose) [Different CT scanning schemes:① 120 kVp+standard dose (n = 123); ② 120 kVp+low dose (n = 71); ③ 140 kVp+standard dose (n = 120); ④ 140 kVp+low dose (n = 69)]. All subjects underwent photoncounting CT liver scanning and MRI examinations, with liver MRI-PDFF used as the reference standard for liver fat quantification. From the standard-dose group (n = 243), this study randomly selected 50 individuals each from the 120 kVp group (n = 123) and 140 kVp group (n = 120) to form a test cohort (n = 100), and the remaining subjects were assigned to the validation cohort (n = 283). Among volunteers with MRI-PDFF < 5% (n = 66) in the test cohort, this study randomly selected 20 individuals each from the 120 kVp group (n = 33) and 140 kVp group (n = 33) to form a threshold adjustment cohort (n = 40). The average CT values of liver and subcutaneous abdominal fat tissues were measured under low and high energy bins to serve as the adjusted thresholds for material decomposition. In the test cohort, the correlation and consistency between CT-FF and MRI-PDFF values obtained using thresholds before (the threshold value provided by the machine itself) and after adjustment (threshold obtained from the adjustment queue) were compared. The performance of the adjusted threshold in measuring liver fat content was evaluated in the validation cohort, as well as the consistency across subgroups with different scanning protocols. Results Based on data from the threshold adjustment cohort, the average CT values of liver tissue at 120 kVp were 65 HU and 70 HU in the low and high energy bins, and so were at 140 kVp. For fat tissue, the average CT values in the low and high energy bins were −127 HU and −96 HU at 120 kVp, and −125 HU and −92 HU at 140 kVp, which were used as the density thresholds for material decomposition. In the test cohort, after threshold adjustment, the correlation (r, 0.98 vs. 0.77), consistency (ICC, 0.980 vs. 0.770; r2, 0.96 vs. 0.60), and mean difference (−0.7% vs. −18.1%) between CT-FF and MRI-PDFF values were significantly improved. In the entire validation cohort and subgroups with different tube voltages and radiation doses, CT-FF and MRI-PDFF showed excellent correlation and consistency (r = 0.99, P < 0.001, r2 = 0.98, ICC = 0.99), with mean differences not exceeding −0.7%. Conclusion Based on the liver tissue characteristics of the Chinese population, this study optimizes the density thresholds of the photon-counting CT material decomposition algorithm, and develops a fat quantification correction standard applicable to Chinese individuals for the first time, significantly improving measurement accuracy. This method may provide a new non-invasive and precise approach for liver fat quantification. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Advances in research on risk factors and associated diseases of intrapancreatic fat deposition LEICHAO Wenwei, RAO Jialing, ZHOU Mengxue, YANG Hong Journal of Diagnostics Concepts & Practice    2025, 24 (01): 72-79.   DOI: 10.16150/j.1671-2870.2025.01.011 Abstract （265）   HTML （7）    PDF（pc） （805KB）（93）       Knowledge map    Save Intrapancreatic fat deposition (IPFD) is defined as the diffuse accumulation of fat within the pancreas. A related term, fatty pancreas (FP), refers to an IPFD fat content of ≥9.5%, which exceeds the normal upper limit. Changes in pancreatic fat content have been shown to affect at least 16% of the global population. Known risk factors for IPFD include demographic characteristics (age, sex, ethnicity), dietary patterns, obesity and metabolic syndrome, non-alcoholic fatty liver disease (NAFLD), metabolic dysfunction-associated steatotic liver disease (MASLD), metabolic dysfunction-associated fatty liver disease (MAFLD), iron overload, genetic disorders, pancreatic duct obstruction, and other potentially related conditions such as bacterial/viral infections, polycystic ovary syndrome, thyroid disorders. Accumulating evidence has established IPFD as a critical risk factor for the pathogenesis and progression of pancreatitis, pancreatic cancer, and diabetes mellitus; additionally, emerging evidence suggests its potential involvement in pancreatic fistula, post-transplant rejection, and atherosclerosis. Currently, the diagnosis of IPFD primarily relies on imaging techniques. With the rapid development of artificial intelligence (AI), AI-assisted imaging is expected to provide more accurate and comprehensive diagnostic tools for IPFD in the near future. Common intervention strategies for IPFD include lifestyle modifications (such as weight loss, dietary optimization, and regular physical activity), pharmacological treatments, and bariatric surgery. Currently, the understanding of IPFD is still unclear, so a review of the risk factors, diagnosis, harms, and intervention measures for IPFD would help improve clinical awareness of IPFD. Reference | Related Articles | Metrics | Comments（0）

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Recent advances in diagnosis and treatment of primary membranous nephropathy HU Xiaofan, XU Jing Journal of Diagnostics Concepts & Practice    2025, 24 (03): 249-254.   DOI: 10.16150/j.1671-2870.2025.03.002 Abstract （265）   HTML （14）    PDF（pc） （771KB）（107）       Knowledge map    Save Primary membranous nephropathy (PMN) has seen a significant global rise in incidence, with data from China showing an annual growth of 13%, making it the leading cause of nephrotic syndrome in people over 40 years old. The diagnosis of PMN traditionally depends on renal biopsy, but recent studies have provided new directions for non-invasive diagnosis. The discovery of anti-phospholipase A2 receptor (PLA2R) antibodies in 2009 marked a milestone in PMN research, and the identification of other target antigens (such as THSD7A and NELL-1) further advanced the understanding of the pathogenesis. Serum PLA2R antibody detection has high specificity but limited sensitivity, potentially lea-ding to missed diagnosis of non-PLA2R-related cases. The combined disease risk score integrating susceptibility loci identified through genome-wide association studies (GWAS) (such as PLA2R1 and HLA-DQA1) with serum antibodies has significantly improved the accuracy of non-invasive diagnosis (area under the receiver operating characteristic curve reaching 0.96). Additionally, gut microbiome analysis demonstrates diagnostic potential, though its clinical application requires further optimization. In terms of advances in prognostic assessment, PMN exhibits remarkable heterogeneity in its natural course, with approximately one-third of patients achieving spontaneous remission and another one-third progressing to renal function decline. Age, proteinuria level, eGFR, PLA2R antibody titer, and the extent of tubulointerstitial lesions are key prognostic predictors. A model combining clinical risk score (CRS) with clinical parameters (such as age, proteinuria, and eGFR) can effectively identify high-risk patients and guide precision treatment. Traditional regimens (such as hormone combined with alkylating agents or calcineurin inhibitors) are effective but have significant toxic side effects. In recent years, anti-CD20 monoclonal antibodies, represented by rituximab (RTX), have become first-line treatments, substantially improving efficacy, though they remain ineffective for some patients. Novel biologics and complement pathway inhibitors provide new options for treatment-resistant patients. Combination strategies (such as RTX combined with tacrolimus) are under investigation, but the balance between efficacy and safety needs to be carefully considered. Future efforts should focus on further optimizing risk stratification and individualized treatment strategies to improve the long-term prognosis of PMN patients. Reference | Related Articles | Metrics | Comments（0）

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Global and Chinese burden of chronic kidney disease due to type 2 diabetes and associated risk factors from 1990 to 2021 SHI Manman, MA Yuhua, ZHENG Jinxin, KE Yanrong, WANG Yuxin, LIU Jian, WANG Weiming Journal of Diagnostics Concepts & Practice    2025, 24 (03): 268-278.   DOI: 10.16150/j.1671-2870.2025.03.005 Abstract （219）   HTML （10）    PDF（pc） （10716KB）（89）       Knowledge map    Save Objective To assess the burden of chronic kidney disease (CKD) caused by type 2 diabetes (T2D) (CKD-T2D) among populations of different ages, genders, regions, and socio-demographic index (SDI) levels globally and in China from 1990 to 2021. Methods Based on data from the 2021 Global Burden of Disease Study (GBD), incidence, prevalence, mortality, and disability-adjusted life years (DALYs) of CKD-T2D in 204 countries and regions were analyzed, with absolute numbers and their 95% uncertainty intervals (UIs) calculated. Results From 1990 to 2021, the global burden of CKD-T2D increased significantly. In 2021, there were 2 012 024 (95%UI: 1 857 800-2 154 288) new cases, marking a 167.2% (95%UI: 153.5%-182.6%) increase from 1990. The age-standardized incidence rate (ASIR) reached 23.07 per 100 000 (95%UI: 21.40-24.72), an increase of 21.0% (15.0%-27.5%) since 1990. Regional analysis showed that North Africa and the Middle East had the highest ASIR (42.802 per 100 000). Compared to 1990, China's CKD-T2D incidence rose significantly to 354,157 cases (95%UI: 321 265-382 784), with crude incidence increasing by 177.6% (95%UI: 154.8%- 205.5%) and ASIR rising slightly by 7.8% [95%UI: (-0.1%) to 17.8%]. For other indicators, crude rates increased whereas age-standardized rates declined. In 2021, CKD-T2D incidence was highest among people aged 65-74 worldwide [364 163 new cases in ages 65-69 (95%UI: 272 571-475 468) and 366 045 in ages 70-74 (95%UI: 286 728-459 891)], with males bearing a higher burden than females [65-69: males 187 097 (95%UI: 140 064-243 571), females 177 066 (95%UI: 132 338-231 769); 70-74: males 187 216 (95%UI: 146 377-234 997), females 178 830 (95%UI: 140 938-224 801)]. SDI stratification indicated that from 1990 to 2021, high-SDI regions had the highest ASIR with a continuous upward trend, while low-SDI regions had the highest mortality rates with limited improvement. Hyperglycemia, obesity, high-calorie diets, and hypertension were the main risk factors for CKD-T2D. Conclusion CKD-T2D remains a major public health issue, with a particularly high disease burden among elderly males and in low- and middle-income countries. While crude rates have risen in China, age-standardized mortality rate (ASMR) and DALYs have declined. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Challenges and solutions in diagnosis and treatment of obesity FANG Ping, HAN Junfeng Journal of Diagnostics Concepts & Practice    2025, 24 (01): 21-26.   DOI: 10.16150/j.1671-2870.2025.01.004 Abstract （213）   HTML （5）    PDF（pc） （759KB）（55）       Knowledge map    Save According to the World Health Organization (WHO), 2.5 billion adults worldwide were overweight, accounting for 43%, and 890 million were obese, accounting for 16% in 2022. Notably, the onset of obesity has shifted towards younger age groups, with a fourfold increase in adolescent obesity cases worldwide since 1990. China has the highest prevalence and growth rate of overweight/obesity globally. According to the latest Report on Residents' Nutrition and Chronic Diseases (2020), China's rate of overweight and obesity in adults has reached 50.7%, a figure projected to reach 65.3% by 2030. Overweight and obesity can lead to metabolic, functional, and psychological disorders, serving as critical risk factors for mortality and disability. They have emerged as one of the greatest medical challenges facing humanity. Currently, overweight/obesity diagnosis relies primarily on body mass index (BMI), body composition analysis, and imaging techniques. Advances in biomarkers and genomics have facilitated the early identification and diagnosis of obesity. However, conventional anthropometric measurements in clinical practice fail to reflect fat distribution or predict disease prognosis. In recent years, experts both in China and abroad have proposed new advanced frameworks for obesity diagnosis and treatment, emphasizing that comprehensive assessment should integrate anthropometric measurements with clinical evaluation of weight-related complications and their severity. Due to regional and ethnic differences in obesity diagnosis, there is an urgent need to develop obesity diagnosis, staging, and management frameworks aligned with the characteristics of China's population, thereby improving the identification of obesity and its related diseases and standardizing patient management strategies. Pharmacotherapy for obesity is favored by many patients due to its good efficacy, compliance, and non-invasive nature. However, pharmacotherapy faces challenges including adverse effects, muscle loss during weight reduction, and weight rebound after discontinuation. Emerging strategies, such as developing small molecule oral drugs, combination therapies, and peptide-drug conjugates, may offer novel solutions to improve tolerability, optimize weight loss experience, and achieve long-term weight maintenance. Reference | Related Articles | Metrics | Comments（0）

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Myeloid sarcoma: clinical features, bone marrow hematological characteristics, and prognosis of 20 cases LIU Xian, HUANG Lifang, MENG Fankai, MENG Li, WANG Zhiqiong Journal of Diagnostics Concepts & Practice    2025, 24 (01): 43-50.   DOI: 10.16150/j.1671-2870.2025.01.007 Abstract （209）   HTML （3）    PDF（pc） （621KB）（74）       Knowledge map    Save Objective To investigate the clinical features and prognosis of myeloid sarcoma (MS). Methods A retrospective analysis was conducted on the clinical data and bone marrow hematological test results of 20 MS patients diagnosed and treated in our department from December 2016 to January 2022. Clinical data were summarized, and the prognosis of three types of MS patients (isolated MS, MS with intramedullary lesions, and secondary MS after AML treatment) was analyzed. Results Among the 20 MS patients, 10 were male and 10 were female. The median age was 37 years (range: 6-62). The most common site of MS was the nasopharynx (25%), followed by the mediastinum (10%), thoracic vertebrae (10%), lymph nodes (10%), breast (10%), cervix (5%), eyes (5%), spleen (5%), testes (5%), abdomen (5%), sacrococcygeal region (5%), and pylorus (5%). There were 10 cases of isolated MS, 6 cases of MS with intramedullary lesions, and 4 cases of secondary MS after AML treatment. Immunohistochemical positive rates, from high to low, were CD99 (100%), CD43 (95%), MPO (95%), BCL-2 (90%), CD68 (75%), CD117 (50%), and CD34 (45%). TdT, CD3, CD20, and PAX-5 were all negative. Fusion gene testing was performed on 17 patients, with 7 positive results (7/17), including 3 cases of AML1-ETO (3/17), 2 cases of CBFβ-MYH11 (2/17), 1 case of MLL-AF10 (1/17), and 1 case of BCR/ABL1 (1/17). Chromosomal karyotype analysis was performed on 17 patients, and 6 showed abnormal karyotypes (6/17). Fluorescence in situ hybridization (FISH) was performed on 4 patients, with 3 positive results (3/4). Genetic mutation testing was conducted on 10 patients, with 9 positive results (9/10). The most frequent mutation was CEBPA (5 cases), followed by NRAS, FLT3, NPM1, and KIT (2 cases each). During the follow-up period of 1-38 months, 7 of the 20 MS patients died, and 13 survived. The cumulative survival rates at 1, 2, and 3 years were 75%, 70%, and 65%, respectively. No statistically significant difference in survival was observed among isolated MS, MS with intramedullary lesions, and secondary MS after AML treatment (P=0.718). Conclusion MS can occur in a wide range of anatomical sites. Pathological immunohistochemical markers, including CD43, CD99, CD68, MPO, CD34, and CD117, are critical for its diagnosis. Bone marrow hematological examination results can provide a basis for targeted therapy. There is no survival difference among the three types of MS patients, and systemic treatment is recommended for all patients. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Research progress on clinical application of anti-tissue factor pathway inhibitor in hemophilia XIAO Jianwen, YI Weijia Journal of Diagnostics Concepts & Practice    2025, 24 (02): 226-232.   DOI: 10.16150/j.1671-2870.2025.02.015 Abstract （208）   HTML （12）    PDF（pc） （612KB）（65）       Knowledge map    Save In recent years， to address the unmet needs in hemophilia treatment， significant research has led to unprecedented advances in pharmacotherapy， including the development of several innovative mechanism-based therapies that restore hemostatic balance by modulating thrombin generation in hemophilia patients with or without inhibitors. Among them， non-factor therapies involving hemostatic rebalancing mechanisms have achieved remarkable progress， with one of the key focuses in clinical development being anti-tissue factor pathway inhibitor （TFPI） therapy. TFPI is a key anticoagulant protein in the coagulation pathway that inhibits tissue factor （TF）-mediated initiation of coagulation. Blocking TFPI activity can enhance thrombin generation， providing a novel approach for hemophilia treatment. Notably， this mechanism applies to patients with hemophilia A or B and is theoretically effective for patients with or without inhibitors. As of June 2025， anti-TFPI agents that have entered clinical development or been approved for marketing internationally include concizumab， marstacimab， befovacimab， KN057， and MG1113. These agents inhibit TFPI activity through different antibody types， employing varying binding affinities or targeting distinct domains of TFPI. Studies on clinical trials across various phases have demonstrated that these drugs have good efficacy in reducing annual bleeding rates and improving patient prognosis. In addition， anti-TFPI drugs are administered subcutaneously， with dosing intervals up to one week， providing convenience for patients. Anti-TFPI therapy represents an important shift in the field of hemophilia management. However， it faces some challenges， including potential thrombotic risks and the current absence of suitable laboratory assays to monitor treatment efficacy. Table and Figures | Reference | Related Articles | Metrics | Comments（0）