Habitat Radiomics Based on MRI for Predicting Platinum Resistance in Patients with High-Grade Serous Ovarian Carcinoma: A Multicenter Study.

RATIONALE AND OBJECTIVES: This study aims to explore the feasibility of MRI-based habitat radiomics for predicting response of platinum-based chemotherapy in patients with high-grade serous ovarian carcinoma (HGSOC), and compared to conventional radiomics and deep learning models. MATERIALS AND METHODS: A retrospective study was conducted on HGSOC patients from three hospitals. K-means algorithm was used to perform clustering on T2-weighted images (T2WI), contrast-enhanced T1-weighted images (CE-T1WI), and apparent diffusion coefficient (ADC) maps. After feature extraction and selection, the radiomics model, habitat model, and deep learning model were constructed respectively to identify platinum-resistant and platinum-sensitive patients. A nomogram was developed by integrating the optimal model and clinical independent predictors. The model performance and benefit was assessed using the area under the receiver operating characteristic curve (AUC), net reclassification index (NRI), and integrated discrimination improvement (IDI). RESULTS: A total of 394 eligible patients were incorporated. Three habitats were clustered, a significant difference in habitat 2 (weak enhancement, high ADC values, and moderate T2WI signal) was found between the platinum-resistant and platinum-sensitive groups (P < 0.05). Compared to the radiomics model (0.640) and deep learning model (0.603), the habitat model had a higher AUC (0.710). The nomogram, combining habitat signatures with a clinical independent predictor (neoadjuvant chemotherapy), yielded a highest AUC (0.721) among four models, with positive NRI and IDI. CONCLUSION: MRI-based habitat radiomics had the potential to predict response of platinum-based chemotherapy in patients with HGSOC. The nomogram combining with habitat signature had a best performance and good model gains for identifying platinum-resistant patients.

Diffusion kurtosis imaging combined with dynamic susceptibility contrast-enhanced MRI in differentiating high-grade glioma recurrence from pseudoprogression.

OBJECTIVES: To compare the added value of diffusion kurtosis imaging (DKI) with the combination of dynamic susceptibility contrast-enhanced (DSC) MRI in differentiating glioma recurrence from pseudoprogression. METHODS: Thirty-four patients with high-grade gliomas developing new and/or increasing enhanced lesions within six months after surgery and chemoradiotherapy were retrospectively analyzed. All patients were pathologically confirmed to have recurrent glioma (n = 22) or pseudoprogression (n = 12). The DKI and DSC MRI parameters were calculated based on the enhanced lesions on contrast-enhanced T1WI. ROC analysis was performed on significant variables to determine their diagnostic performance. Multivariate logistic regression was used to determine the best prediction model for discrimination. RESULTS: The relative mean kurtosis (rMK), relative axial kurtosis (rKa), relative cerebral blood volume (rCBV), and relative mean transit time (rMTT) of glioma recurrence were higher than those of pseudoprogression (all, P < 0.05). The AUCs and diagnostic accuracy were 0.879 and 82.35% for rMK, 0.723 and 70.59% for rKa, 0.890 and 82.35% for rCBV, 0.765 and 73.53% for rMTT, respectively. A multivariate logistic regression model showed a significant contribution of rMK (P = 0.006) and rCBV (P = 0.009) as independent imaging classifiers for discrimination. The combined use of rMK and rCBV improved the AUC to 0.924 (P < 0.001) and the diagnostic accuracy to 88.24%. CONCLUSION: DKI may be a valuable non-invasive tool in differentiating glioma recurrence from pseudoprogression, and its use in combination with DSC MRI can improve diagnostic performance in assessing treatment response compared with either technique alone.

Hydatidiform mole in a scar on the uterus: A case report.

BACKGROUND: Cesarean scar molar pregnancy is extremely rare, but the incidence has been rising due to the continuous increase in the rate of cesarean section. The presence of a hydatidiform mole in the scar left on the uterus by the procedure may lead to severe complications. We performed a literature review and found only seven reported cases of cesarean scar molar pregnancy. Accurate diagnosis and appropriate treatment are extremely important for the patients' prognosis. CASE SUMMARY: A 35-year-old woman, gravida 4, para 1, complained of vaginal bleeding lasting more than 1 mo and amenorrhea lasting more than 2 mo. The patient's serum human chorionic gonadotropin was 4287800 IU/L. Ultrasound showed a 11.5 cm × 7.5 cm mass at the anterior lower wall of the uterus. The patient underwent suction evacuation, and partial grape-like tissue mixed with blood clots was removed. Uterine arterial embolization was performed to control intraoperative and postoperative bleeding. Histological examination confirmed the presence of a hydatidiform mole in uterine scar. After surgery, there was still a mass with heterogeneous intensity near the isthmus of the uterus on magnetic resonance imaging. The patient then underwent chemotherapy. During the 6-mo follow-up period, the mass disappeared and the serum human chorionic gonadotropin level gradually decreased to normal level. CONCLUSION: We report a case of cesarean scar molar pregnancy successfully cured by comprehensive treatment. We found that cesarean scar molar pregnancy was subject to intraoperative bleeding, and uterine arterial embolization before surgery may be helpful.

Assessment of Split Renal Function Using a Combination of Contrast-Enhanced CT and Serum Creatinine Values for Glomerular Filtration Rate Estimation.

OBJECTIVE. The objective of our study was to develop a novel method to estimate single-kidney glomerular filtration rate (GFR) using a combination of contrast-enhanced CT and serum creatinine (SCr) values and to validate the resulting estimated glomerular filtration rates (eGFRs) by comparing them with the single-kidney Gates GFR, which is based on renal dynamic imaging. MATERIALS AND METHODS. Sixty-two patients with asymmetric renal disease who underwent unenhanced and triphasic contrast-enhanced CT of the kidneys, 99mTc-diethylenetriamine pentaacetic acid renal dynamic imaging, and SCr testing within 1 week were retrospectively included. The eGFR was split into single-kidney GFRs of the left and right kidneys by a proportionality factor derived from the products of renal volume and CT number increments of the multiphasic CT images, which produced unenhanced phase (yielded by the renal volume proportional factor alone), arterial phase, venous phase, and nephrographic phase CT split eGFRs. The four CT split eGFRs were compared with the Gates GFR using the paired-sample t test, Pearson correlation analysis, and Bland-Altman analysis. RESULTS. Correlation coefficients and 95% CIs between the four CT split eGFRs and Gates GFR were as follows: unenhanced phase, 0.729 (95% CI, 0.626-0.805); arterial phase, 0.781 (95% CI, 0.685-0.849); venous phase, 0.788 (95% CI, 0.690-0.839); and nephrographic phase, 0.842 (95% CI, 0.758-0.902) (all, p < 0.001). The paired differences between the CT split eGFRs and Gates GFR were as follows: unenhanced phase, 2.04 ± 10.85 (95% CI, 0.01-4.07) mL/min/1.73 m2; arterial phase, 2.04 ± 10.56 (95% CI, 0.06-4.02) mL/min/1.73 m2; venous phase, 2.04 ± 10.04 (95% CI, 0.16-3.92) mL/min/1.73 m2; and nephrographic phase, 2.04 ± 8.92 (95% CI, 0.37-3.71) mL/min/1.73 m2. These results suggest a maximum deviation from the Gates GFR of ± 44.9% for the unenhanced phase eGFR, ± 43.7% for the arterial phase eGFR, ± 41.6% for the venous phase eGFR, and ± 36.9% for nephrographic phase eGFR. CONCLUSION. Split renal function can be estimated using a combination of contrast-enhanced CT and SCr values to calculate eGFR. The CT images of the nephrographic phase may be the optimal choice to use in this proposed method.

Dual Plasma Sampling Method to Determine the Hepatic and Renal Clearance of the 2 Diastereoisomers of Gd-EOB-DTPA.

OBJECTIVES: The aim of this study was to develop a method to determine hepatic and renal clearance of the 2 diastereoisomers (Gd-A, Gd-B) of Gd-EOB-DTPA separately. MATERIALS AND METHODS: Between July 2017 and February 2018, 41 patients with hepatic disease were prospectively included. For each patient, 1 mL of iopromide (to determine glomerular filtration rate [GFR]) was coadministered with Gd-EOB-DTPA (Gd-A and Gd-B; 65:35 wt/wt). The plasma clearances of Gd-A (PCL-GdA) and Gd-B (PCL-GdB) as well as the iopromide (GFR) were generated by using dual plasma sampling method. Meanwhile, the patient's urine was collected for measurement of renal clearance of Gd-A (RCL-GdA) and Gd-B (RCL-GdB) to confirm its agreement with GFR. Hepatic clearances of Gd-A (HCL-GdA) and Gd-B (HCL-GdB) were calculated by subtracting the GFR from PCL-GdA and PCL-GdB, respectively, and were correlated with indocyanine green (ICG) 15 minutes retention rate (ICG R15). Pharmacokinetic parameters were compared between the two isomers and between Child-Pugh classifications using student's t test. RESULTS: Within the group of 41 patients evaluated, both RCL-GdA and RCL-GdB demonstrated a good correlation and agreement to GFR (statistics shown in the main body). HCL-GdA demonstrated a strong negative correlation (r = -0.86, P < 0.001) with ICG R15 and was much higher than HCL-GdB (116.18 ± 75.48 vs 19.74 ± 14.24 mL/min, P < 0.001). HCL-GdB demonstrated a weak correlation (r = -0.26, P = 0.102) with ICG R15. HCL-GdA of noncirrhosis and Child-Pugh class A (151.74 ± 68.28 mL/min, n = 26) was higher than that of Child-Pugh class B (54.54 ± 39.13 mL/min, n = 15; P = 0.001). CONCLUSIONS: A practical method was established for the determination of hepatic and renal clearance of the 2 isomers of Gd-EOB-DTPA. The 2 isomers have equal renal clearance and different hepatic clearance. The HCL-GdA may serve as a novel marker to reflect liver function reserve.

Determination of glomerular filtration rate (GFR) from fractional renal accumulation of iodinated contrast material: a convenient and rapid single-kidney CT-GFR technique.

OBJECTIVES: To develop a convenient and rapid single-kidney CT-GFR technique. METHODS: One hundred and twelve patients referred for multiphasic renal CT and 99mTc-DTPA renal dynamic imaging Gates-GFR measurement were prospectively included and randomly divided into two groups of 56 patients each: the training group and the validation group. On the basis of the nephrographic phase images, the fractional renal accumulation (FRA) was calculated and correlated with the Gates-GFR in the training group. From this correlation a formula was derived for single-kidney CT-GFR calculation, which was validated by a paired t test and linear regression analysis with the single-kidney Gates-GFR in the validation group. RESULTS: In the training group, the FRA (x-axis) correlated well (r = 0.95, p < 0.001) with single-kidney Gates-GFR (y-axis), producing a regression equation of y = 1665x + 1.5 for single-kidney CT-GFR calculation. In the validation group, the difference between the methods of single-kidney GFR measurements was 0.38 ± 5.57 mL/min (p = 0.471); the regression line is identical to the diagonal (intercept = 0 and slope = 1) (p = 0.727 and p = 0.473, respectively), with a standard deviation of residuals of 5.56 mL/min. CONCLUSION: A convenient and rapid single-kidney CT-GFR technique was presented and validated in this investigation. KEY POINTS: • The new CT-GFR method takes about 2.5 min of patient time. • The CT-GFR method demonstrated identical results to the Gates-GFR method. • The CT-GFR method is based on the fractional renal accumulation of iodinated CM. • The CT-GFR method is achieved without additional radiation dose to the patient.

Determination of single-kidney glomerular filtration rate (GFR) with CT urography versus renal dynamic imaging Gates method.

OBJECTIVES: To present a single-kidney CT-GFR measurement and compare it with the renal dynamic imaging Gates-GFR. MATERIALS AND METHODS: Thirty-six patients with hydronephrosis referred for CT urography and 99mTc-DTPA renal dynamic imaging were prospectively included. Informed consent was obtained from all patients. The CT urography protocol included non-contrast, nephrographic, and excretory phase imaging. The total CT-GFR was calculated by dividing the CT number increments of the total urinary system between the nephrographic and excretory phase by the products of iodine concentration in the aorta and the elapsed time, then multiplied by (1- Haematocrit). The total CT-GFR was then split into single-kidney CT-GFR by a left and right kidney proportionality factor. The results were compared with single-kidney Gates-GFR by using paired t-test, correlation analysis, and Bland-Altman plots. RESULTS: Paired difference between single-kidney CT-GFR (45.02 ± 13.91) and single-kidney Gates-GFR (51.21 ± 14.76) was 6.19 ± 5.63 ml/min, p<0.001, demonstrating 12.1% systematic underestimation with ±11.03 ml/min (±21.5%) measurement deviation. A good correlation was revealed between both measurements (r=0.87, p<0.001). CONCLUSION: The proposed single-kidney CT-GFR correlates and agrees well with the reference standard despite a systematic underestimation, therefore it could be a one-stop-shop for evaluating urinary tract morphology and split renal function. KEY POINTS: • A new CT method can assess split renal function • Only using images from CT urography and the value of haematocrit • A one-stop-shop CT technique without additional radiation dose.

[SNP of rs17321515 homologous with Trib1 in Han population and its correlation with blood lipid].

OBJECTIVE: To study on genotype distribution of rs17321515 which is homologous with Trib1 and its associativity with blood lipid parameters and diagnosis. METHOD: Collecting 1 014 blood samples to measure its lipid levels, then detecting rs17321515 locus's SNP by MALDI-TOF mass spectrometry technology. RESULTS: Three genotypes (A/A, A/G, G/G) proportions in the population were 13.8%, 50.2% and 36.0%, allele frequencies were A: G = 38.9% : 61.1%. In variance analysis, variation of TG of male was statistical significant (F = 4.46, P = 0.01), TG level of male who carried AG is lower than GG carries ( t = 0.29, P = 0.02). Logistic regression analysis showed that, hypertriglyceridemia prevalence of male who carried AA is lower than GG carries (OR = 0.45, P = 0.04). Low HDL-c acidosis prevalence of male who carried AG is lower than GG carries (OR = 0.62, P = 0.03). Hypercholesterolemia prevalence of female who carried AG is lower than GG carries (OR = 0.58, P = 0.01). CONCLUSION: Allele frequencies of rs17321515 varies in different ethnic groups; The locus' polymorphism distribution is relevant with a certain lipid indicators and lipid diagnosis, but there exist gender differences on these relevance.

Overexpression of profilin 3 affects cell elongation and F-actin organization in Arabidopsis thaliana.

KEY MESSAGE : Reduced levels of profilin 3 do not have a noticeable phenotypic effect; however, elevated profilin 3 levels result in decreased hypocotyl length due to a reduction in cell elongation and F-actin reorganization. The actin cytoskeleton is critical for a variety of cellular processes. The small actin monomer proteins, profilins (PRFs), are encoded by five highly conserved isoforms in Arabidopsis thaliana. PRF3, one of the vegetative isoforms, has 36 more N-terminal amino acid residues than the other four PRFs; however, the functions of PRF3 are mostly unknown. In this study, we demonstrated that PRF3 was strongly expressed in young seedlings, rosette leaves, and cauline leaves, but was weakly expressed in 14-day-old seedlings and flowers. Our data also showed that PRF3 could increase the critical concentration (Cc) of actin assembly in vitro. Overexpression of the full-length PRF3 cDNA resulted in a decrease in the lengths of roots and hypocotyls and delayed seed germination, but PRF3-ΔN36 transgenic plants and prf3 mutant plants showed normal growth when compared with wild-type plants. Microscopy observation revealed that cell elongation was inhibited in the hypocotyl and that F-actin was reorganized by destabilizing microfilaments. These results suggest that the dwarf phenotype of the PRF3 overexpression seedlings may be related to a reduction in cell length and F-actin rearrangement.