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扩散峰度成像用于评估肝细胞癌经动脉化疗栓塞术的治疗反应

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

作者信息

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

机构信息

Shandong Medical Imaging Research Institute Affiliated to Shandong University, Jinan 250021 P. R. China.

Medical Imaging Center of the Affiliated Hospital, Weifang Medical University, Weifang 261053 P. R.China.

出版信息

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

Abstract

: This study aimed to evaluate the therapeutic response of hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE) with diffusion kurtosis imaging (DKI). : 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, 2,000mm/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. : 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±0.36×10mm/s, 1.36±0.23×10mm/s) were greater than progressing groups (1.44±0.32× 10mm/s, 1.10±0.23×10mm/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) (<0.05). In the non-progressing groups, the MD and ADC values of tumor after TACE (1.92±0.36×10mm/s, 1.36±0.23×10mm/s) became higher than their preoperative values (1.44±0.35×10mm/s, 1.09±0.22×10mm/s) (<0.05). In the progressing groups, the MK, MD, and ADC values of tumor after TACE remained similar before TACE (>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). : 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.

摘要

本研究旨在通过扩散峰度成像(DKI)评估经动脉化疗栓塞术(TACE)治疗后肝细胞癌(HCC)的治疗反应。本研究招募了43例患有59个肝癌结节的患者。所有患者均接受TACE治疗。在开始TACE治疗前及治疗后1个月进行磁共振成像(MRI)和DKI检查(b = 0、800、1500、2000mm/s)。将患者分为进展组和非进展组。分析肿瘤组织的平均峰度(MK)、平均扩散率(MD)和表观扩散系数(ADC)值。23个HCC被归类为进展组,36个HCC为非进展组。TACE治疗后,非进展组的MD和ADC值(1.92±0.36×10mm/s,1.36±0.23×10mm/s)高于进展组(1.44±0.32×10mm/s,1.10±0.23×10mm/s),然而,非进展组的MK值(0.47±0.12)低于进展组(0.72±0.14)。非进展组患者TACE治疗1个月后肿瘤的MK值(0.47±0.12)相对于术前值(0.71±0.12)降低(<0.05)。在非进展组中,TACE治疗后肿瘤的MD和ADC值(1.92±0.36×10mm/s,1.36±0.23×10mm/s)高于术前值(1.44±0.35×10mm/s,1.09±0.22×10mm/s)(<0.05)。在进展组中,TACE治疗后肿瘤的MK、MD和ADC值与TACE治疗前相似(>0.05)。通过MK评估TACE治疗后HCC进展的ROC曲线的敏感性、特异性和AUC(分别为85.2%、97.5%和0.95)大于通过ADC(分别为78.6%、66.5%和0.75)和MD(分别为76.2%、64.3%和0.71)评估。DKI用于评估TACE治疗HCC的治疗反应显示出巨大前景。MK在评估TACE治疗后HCC进展方面更具优势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce40/7052943/9d8065dd83fe/jcav11p2339g001.jpg

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