Diffusion Kurtosis Imaging for Assessing the Therapeutic Response of Transcatheter Arterial Chemoembolization in Hepatocellular Carcinoma

Zhen-Guo Yuan; Zong-Ying Wang; Meng-Ying Xia; Feng-Zhi Li; Yao Li; Zhen Shen; Xi-Zhen Wang

doi:10.7150/jca.32491

Diffusion Kurtosis Imaging for Assessing the Therapeutic Response of Transcatheter Arterial Chemoembolization in Hepatocellular Carcinoma

J Cancer. 2020 Feb 10;11(8):2339-2347. doi: 10.7150/jca.32491. eCollection 2020.

Authors

Zhen-Guo Yuan¹, Zong-Ying Wang², Meng-Ying Xia¹, Feng-Zhi Li², Yao Li¹, Zhen Shen², Xi-Zhen Wang²

Affiliations

¹ Shandong Medical Imaging Research Institute Affiliated to Shandong University, Jinan 250021 P. R. China.
² Medical Imaging Center of the Affiliated Hospital, Weifang Medical University, Weifang 261053 P. R.China.

Abstract

Objective: This study aimed to evaluate the therapeutic response of hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE) with diffusion kurtosis imaging (DKI). Methods: Forty-three patients with fifty-nine hepatic cancer nodules were recruited for this study. All patients were treated by TACE. Magnetic resonance imaging (MRI) and DKI (b=0, 800, 1,500, 2,000mm²/s) were performed before and one month after initiating TACE. Patients were classified as either progressing groups or non-progressing groups. Mean kurtosis (MK), mean diffusion (MD), and apparent diffusion coefficient (ADC) values of the tumor tissue were analyzed. Results: Twenty-three HCCs were classified as progressing groups, and thirty-six HCCs were non-progressing groups. After TACE, the values of MD and ADC in non-progressing groups (1.92±0.36×10^-3mm²/s, 1.36±0.23×10^-3mm²/s) were greater than progressing groups (1.44±0.32× 10^-3mm²/s, 1.10±0.23×10^-3mm²/s), however, the MK values in non-progressing groups (0.47±0.12) were lower than progressing groups (0.72±0.14). The MK values of tumor among non-progressing patients decreased one month after TACE (0.47±0.12) relative to the preoperative values (0.71±0.12) (P<0.05). In the non-progressing groups, the MD and ADC values of tumor after TACE (1.92±0.36×10^-3mm²/s, 1.36±0.23×10^-3mm²/s) became higher than their preoperative values (1.44±0.35×10^-3mm²/s, 1.09±0.22×10^-3mm²/s) (P<0.05). In the progressing groups, the MK, MD, and ADC values of tumor after TACE remained similar before TACE (P>0.05). The sensitivity, specificity, and AUC of the ROC curve for the assessment of HCC progress after TACE by MK (85.2%, 97.5%, and 0.95, respectively) were greater than by ADC (78.6%, 66.5%, and 0.75, respectively) and MD (76.2%, 64.3%, and 0.71, respectively). Conclusions: DKI for assessing the therapeutic response of TACE in HCC shows great promise. MK is more advantageous in the assessment of HCC progress after TACE.

Keywords: diffusion kurtosis imaging; hepatocellular carcinoma; transcatheter arterial chemoembolization.

Publication types

Review