BackgroundT1ρ and T2* relaxation times are capable of providing information about early biochemical changes in intervertebral disk degeneration (IVDD). The purpose of this study was to assess and compare T1ρ and T2* mapping in IVDD with reference to Pfirrmann grade.Material/MethodsLumbar sagittal T2-weighted, T1ρ and T2* relaxation MRI were performed at 3.0T in 42 subjects covering discs L1–L2 to L5–S1. All the discs were morphologically assessed according to the Pfirrmann grade. Regions of interest (ROIs) were drawn over the T1ρ and T2*mappings, including nucleus pulposus (NP) and annulus fibrosus (AF). Wilcoxon signed rank test, Kruskal-Wallis test, and Spearman rank correlation were performed.ResultsThe difference in T1ρ and T2* values between NP and AF were highly significant (P<0.001). The trends of decreasing T1ρ and T2* values of both NP and AF with increasing Pfirrmann grades was significant (P<0.01), particularly between Pfirrmann grade II and III (P<0.001), whereas T2* mapping was additionally able to detect changes in the AF between Pfirrmann grade I and II (P<0.05). Pfirrmann grades were inversely significantly correlated with both T1ρ and T2* values in the NP (r=–0.69, P<0.001; r=−0.56, P<0.001) and AF (r=−0.45, P<0.001; r=−0.26, P<0.001).ConclusionsThe process of IVDD can be detected by T1ρ and T2* mapping, particularly at early stage, and both methodologies displayed roughly comparable performance.
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, 2,000mm 2 /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 − 3 mm 2 /s, 1.36±0.23×10 − 3 mm 2 /s) were greater than progressing groups (1.44±0.32× 10 − 3 mm 2 /s, 1.10±0.23×10 − 3 mm 2 /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 − 3 mm 2 /s, 1.36±0.23×10 − 3 mm 2 /s) became higher than their preoperative values (1.44±0.35×10 − 3 mm 2 /s, 1.09±0.22×10 − 3 mm 2 /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.
Purpose: To investigate the diagnostic efficacy of diffusion kurtosis imaging (DKI) and conventional diffusion-weighted imaging (DWI) for pathological grading. Methods: From December 2015 to January 2017, consecutive patients suspected of having hepatocellular carcinoma (HCC) without prior treatment were prospectively enrolled in this study. MRI examinations were performed before surgical treatment. HCC patients confirmed by surgical pathology were included in the study. The mean diffusivity (MD) values, mean kurtosis (MK) values, and apparent diffusion coefficient (ADC) were calculated. The differences and correlations of these parameters among different pathological grades were analyzed. The diagnostic efficiency of DKI and DWI for predicting high-grade HCC was evaluated by receiver operating characteristic (ROC) curves. Logistic regression analyses were used to evaluate the predictive factors for pathological grade. Results: A total of 128 patients (79 males and 49 females, age: 56.9±10.9 years, range, 32-80) with primary HCC were included: grade I: 22 (17.2%) patients, grade II: 37 (28.9%) patients, grade III: 43 (33.6%) patients, grade IV: 26 (20.3%) patients. The MK values of stage I, II, III, and IV were 0.86±0.13, 1.06±0.11, 1.27±0.17, and 1.57±0.13, respectively. The MK values were significantly higher in the high-grade group than in the low-grade group and were positively correlated with pathological grade (rho =0.7417, P<0.001). The MK value demonstrated a larger area under the curve (AUC), with a value of 0.93 than the MD value, which had an AUC of 0.815 (P<0.001), and ADC, which had an AUC of 0.662 (P=0.01). The MK value (>1.19), ADC (≤1.29×10 -3 mm 2 /s), and HBV (+) were independent predictors for the pathological grade of HCCs. Conclusion:The MK values derived from DKI and the ADC values obtained from traditional DWI were more valuable than the MD values in predicting the histological grade of HCCs and could potentially guide clinical treatment before surgery.
Objective This study aimed to compare the diffusion kurtosis imaging (DKI) versus diffusion weighted imaging (DWI) in predicting the recurrence of early stage single nodules of hepatocellular carcinoma (HCC) treated by radiofrequency ablation (RFA). Materials and methods A retrospective analysis of 107 patients with early stage single nodules of HCC was performed, all patients treated by RFA. Recurrence rate of HCC was recorded after a median follow-up of 36 months. During follow-up, the data of magnetic resonance imaging (MRI), DWI and DKI were obtained in multiple time points. The predictive values of DWI and DKI were analyzed using ROC curves. Results The overall recurrence rate was 66.3% (71/107). The sensitivity, specificity, and AUC for ADC, MD and MK after RFA (78.6, 73.3% and 0.842; 85.7, 83.3% and 0.839; 85.7, 96.7% and 0.956) were higher than before RFA (44.3, 53.3% and 0.560; 51.2, 56.7% and 0.543; 43.6, 67.3% and 0.489). The sensitivity, specificity, and AUC for MK after RFA were 85.7, 96.7%, and 0.956, respectively, which were significantly greater than those of ADC (78.6, 73.3% and 0.842; P < 0.05) and MD (85.7, 83.3% and 0.839). Conclusions The prediction efficacy of DKI for the recurrence of early stage single nodules of HCC was better than that of DWI. And, MK was the most sensitive predictor among the DKI.
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