Diffusion Tensor and Kurtosis MRI-Based Radiomics Analysis of Kidney Injury in Type 2 Diabetes.

BACKGROUND: Diffusion tensor imaging (DTI) and diffusion kurtosis imaging (DKI) can provide quantitative parameters that show promise for evaluation of diabetic kidney disease (DKD). The combination of radiomics with DTI and DKI may hold potential clinical value in detecting DKD. PURPOSE: To investigate radiomics models of DKI and DTI for predicting DKD in type 2 diabetes mellitus (T2DM) and evaluate their performance in automated renal parenchyma segmentation. STUDY TYPE: Prospective. POPULATION: One hundred and sixty-three T2DM patients (87 DKD; 63 females; 27-80 years), randomly divided into training cohort (N = 114) and validation cohort (N = 49). FIELD STRENGTH/SEQUENCE: 1.5-T, diffusion spectrum imaging (DSI) with 9 different b-values. ASSESSMENT: The images of DSI were processed to generate DKI and DTI parameter maps, including fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD). The Swin UNETR model was trained with 5-fold cross-validation using 100 samples for renal parenchyma segmentation. Subsequently, radiomics features were automatically extracted from each parameter map. The performance of the radiomics models on the validation cohort was evaluated by utilizing the receiver operating characteristic (ROC) curve. STATISTICAL TESTS: Mann-Whitney U test, Chi-squared test, Pearson correlation coefficient, least absolute shrinkage and selection operator (LASSO), dice similarity coefficient (DSC), decision curve analysis (DCA), area under the curve (AUC), and DeLong's test. The threshold for statistical significance was set at P < 0.05. RESULTS: The DKI_MD achieved the best segmentation performance (DSC, 0.925 ± 0.011). A combined radiomics model (DTI_FA, DTI_MD, DKI_FA, DKI_MD, and DKI_RD) showed the best performance (AUC, 0.918; 95% confidence interval [CI]: 0.820-0.991). When the threshold probability was greater than 20%, the combined model provided the greatest net benefit. Among the single parameter maps, the DTI_FA exhibited superior diagnostic performance (AUC, 887; 95% CI: 0.779-0.972). DATA CONCLUSION: The radiomics signature constructed based on DKI and DTI may be used as an accurate and non-invasive tool to identify T2DM and DKD. LEVEL OF EVIDENCE: 2 TECHNICAL EFFICACY: Stage 2.

Management of Chronic Portal Vein Thrombosis in a Cirrhotic Patient With Pancytopenia and Grade II Esophageal Varices.

Chronic portal vein thrombosis (PVT) is a major vascular complication of liver cirrhosis. Patients may be asymptomatic and chronic PVT might be detected incidentally on imaging. PVT is associated with worsening liver disease, poorer clinical outcomes, and might proceed to life-threatening intestinal ischemia. Management of chronic PVT with anticoagulation has been shown to be successful in promoting recanalization and reducing thrombus extension in patients with cirrhosis. However, optimal anticoagulation for PVT in cirrhosis has not yet been addressed in any large-scale trial, and the decision to anti-coagulate varies on a case by case presentation. We report the case of a 62-year-old male patient with a history of liver cirrhosis, pancytopenia, and grade II esophageal varices presenting with abdominal pain who was incidentally found to have chronic thrombosis of the portal vein on imaging and was managed appropriately with a good outcome.

MIC3, a novel cross-protective antigen expressed in Toxoplasma gondii and Neospora caninum.

Microneme protein 3 (MIC3) is an important adhesion molecule expressed by Toxoplasma gondii and Neospora caninum that plays a crucial role in invasion. In our study, we found that recombinant TgMIC3 (rTgMIC3) was recognized by both T. gondii-reactive sera and hyper-immune serum against N. caninum. Polyclonal antibodies against TgMIC3 reacted with N. caninum by western blot and immunofluorescence assay (IFA). These results indicate that MIC3 is a novel cross-reactive antigen expressed in N. caninum and T. gondii. To evaluate the immune-protective effect of TgMIC3, we created the eukaryotic expression vector pcDNA3.1-TgMIC3, transfected this vector into HEK293T cells by lipofection, and evaluated TgMIC3 expression in HEK293T cells using western blot and IFA. Then, groups of BALB/c mice were immunized with recombinant TgMIC3 protein, pcDNA3.1-TgMIC3, or two-vaccine immunization. The mice were challenged with T. gondii RH or N. caninum Nc-1 tachyzoites 14 days after the final immunization. The survival time of T. gondii-infected mice was recorded, and the parasite burden in the brain of N. caninum-infected mice 30 days post-infection was measured using real-time PCR. The results demonstrated that mice immunized with TgMIC3-based vaccines elicited high antibody titers. After parasitic challenge, mice immunized with pcDNA-TgMIC3 exhibited prolonged survival when infected with T. gondii tachyzoites and a lower parasitic burden in the brains of mice challenged with N. caninum tachyzoites. These results demonstrate that TgMIC3 is a cross-protective antigen expressed in T. gondii and N. caninum and could elicit some protection against toxoplasmosis and neosporosis.

First isolation of Neospora caninum from blood of a naturally infected adult dairy cow in Beijing, China.

Neospora caninum is an important cause of abortion in cattle worldwide, but the isolation of a viable parasite from an abortus is difficult, and viable N. caninum has not been isolated from any host in China. In the present study, peripheral blood samples were collected from a jugular vein of an adult dairy cow that had aborted; the cow was seropositive to N. caninum antibodies by ELISA. White blood cells were separated and seeded onto Vero cell monolayer cultures for parasite isolation. Tachyzoites were first observed in cell culture on day 84 after initial inoculation. The parasite was confirmed to be N. caninum by gene sequencing and immunofluorescence, and by bioassays in BALB/c mice. The new N. caninum isolate (NC-Bj) has a unique pattern on microsatellite Cont-14. To our knowledge, this is the first successful isolation of N. caninum in China from any host.

Toxoplasma gondii immune mapped protein-1 (TgIMP1) is a novel vaccine candidate against toxoplasmosis.

Immune mapped protein1 (IMP1) is a new protective protein in apicomplexan parasites, and exists in Toxoplasma gondii. In the present study, a DNA vaccine expressing IMP1 of T. gondii was constructed and the immune response induced in BALB/c mice was evaluated. The coding sequence of IMP1 was inserted into the eukaryotic expression vector pcDNA 3.1(+), resulting a recombinant plasmid pcDNA-IMP1, which was used to immunize BALB/c mice intramuscularly. After immunization, the immune response was evaluated using lymphoproliferative assay, and cytokine and antibody measurements. The mice were challenged with tachyzoites of the virulent T. gondii RH strain 14th day after the last immunization to observe the survival time. The results showed that the group immunized with pcDNA-IMP1 developed a high level of specific antibody responses against Escherichia coli expressed recombinant TgIMP1, with high IgG antibody titers, predominance of IgG2a production, a strong lymphoproliferative response, and significant levels of IFN-γ, IL-2, IL-4 and IL-10 production compared with the control groups. These results demonstrate that pcDNA-IMP1 could elicit strong humoral and Th1 immune responses. Immunized mice showed a significantly (15.8 ± 6 days) prolonged survival time compared with control mice, which died within 7 days of challenge infection. These results suggest that IMP1 is a promising vaccine candidate against toxoplasmosis.