Yuan Zhen-Guo, Wang Zong-Ying, Xia Meng-Ying, Li Feng-Zhi, Li Yao, Shen Zhen, Wang Xi-Zhen
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.
J Cancer. 2020 Feb 10;11(8):2339-2347. doi: 10.7150/jca.32491. eCollection 2020.
: 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.
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。