The majority of congenital cytomegalovirus (cCMV) infections are asymptomatic at birth and therefore not diagnosed. Approximately 10-15% of these infants develop late-onset hearing loss and other developmental disorders. Implementation of a universal screening approach at birth may allow early initiation of symptomatic interventions due to a closer follow-up of infants at risk and offers the opportunity to consider treatment of late-onset disease. Realtime PCR assays for the detection of CMV DNA in buccal swab samples demonstrated feasibility and good clinical sensitivity in comparison to a rapid culture screening assay. Because most cCMV infections remain asymptomatic, a universal screening assay that stratifies CMV infected infants according to low and high risk of late-onset cCMV disease could limit the parental anxiety and reduce follow-up costs. We therefore developed and characterized a screening algorithm based on a highly-sensitive quantitative real-time PCR assay that is compatible with centralized testing of samples from universal screening and allows to determine CMV DNA load of saliva samples either as International Units (IU)/ml saliva or IU/10 5 cell equivalents. 18 of 34 saliva samples of newborns that tested positively by the screening algorithm were confirmed by detection of CMV DNA in blood and/or urine samples obtained during the first weeks of life. All screening samples that could not be confirmed had viral loads of <2.3x10 5 IU/ml saliva (median: 6.8x10 3) or 1.3x10 5 IU/10 5 cell equivalents (median: 4.0x10 2). The viral load of screening samples with confirmed cCMV infection ranged from 7.5x10 2 to 8.2x10 9 IU/ml saliva (median: 9.3x10 7) or 1.5x10 2 to 5.6x10 10 IU/10 5 cell equivalents (median: 3.5x10 6). Clinical follow-up of these newborns with confirmed cCMV infection should reveal whether the risk of late-onset cCMV disease correlates with CMV DNA load in early life saliva samples and whether a cutoff can

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BackgroundDecrease of proteoglycan is the initiating stage of post-inflammatory tissue degradation. Sodium MRI is promising great potential for identification and monitoring of proteoglycan changes in tendons and cartilage associated with inflammatory and degenerative musculoskeletal diseases, where the Achilles tendon is frequently affected.ObjectivesProof-of-concept study to examine the usage of sodium MRI in quantifying sodium concentrations in the Achilles tendon in healthy volunteers.MethodsSodium (23Na) MR imaging of the Achilles tendon together with established proton (1H) MRI sequences were performed in 10 healthy volunteers (6 males, 4 females, age 29 ± 9 years) using a dual-tuned 23Na/1H surface coil (RAPID Biomedical GmbH, Würzburg-Rimpar, Germany). Imaging was performed using a 3D density adapted radial sequence [1] providing sufficient signal-to-noise ratio for sodium imaging. Reference tubes on the backside of the coil were used to enable assessment of sodium concentration from sodium signal-to-noise ratio maps. Sodium concentrations were determined for tendon insertion into calcaneus bone (INS), middle portion of the tendon (MID) and muscle-tendon junction (MTJ) and for the whole Achilles tendon. Statistical differences were analysed by Wilcoxon test.ResultsSodium concentrations c [mM] of the Achilles tendon could be quantified in all 10 (exemplary selected volunteer is shown in Figure 1). Significantly higher sodium concentrations were obtained in INS compared to MID (p=0.002) and MTJ (p=0.002) and in MID compared to MTJ (p=0.037). The average sodium concentration of the whole Achilles tendon was 57.23±17.69 mM with only minor outliers in this healthy population.Figure 1.Sodium concentrations of the Achilles tendon. Highest sodium concentrations c(mM) were observed at the tendon insertion into calcaneus bone (INS), whereas lower concentrations were measured in the middle portion of the tendon (MID) and muscle-tendon junction (MTJ).ConclusionPerformance of quantitative sodium imaging of the Achilles tendon in a high-field MRI machine is feasible for assessing sodium concentrations, a surrogate biomarker for proteoglycan content. Molecular MR studies investigating changes in the proteoglycan content of the Achilles tendon in patients with inflammatory and degenerative musculoskeletal diseases could support early diagnosis or therapy monitoring in the future.References[1]Nagel et al. Magn Reson Med (2009) 62(6):1565-73. DOI: 10.1002/mrm.22157Disclosure of InterestsNone declared