Role of Diffusional Kurtosis Imaging in Evaluating the Efficacy of Transcatheter Arterial Chemoembolization in Patients with Liver Cancer.

Objective

To explore the role of diffusional kurtosis imaging (DKI) in evaluating the efficacy of transcatheter arterial chemoembolization (TACE) in patients with liver cancer. Materials and

Methods

A total of 54 patients with primary liver cancer underwent TACE were selected as the study subjects. Magnetic resonance imaging and DKI scans were carried out before and after TACE, and the relevant parameters were analyzed.

Results

Compared with those before TACE, the values of radial diffusivity (Dr), axial diffusivity (Da), and mean diffusivity (MD) of tumor tissues in the patients after TACE were significantly increased, whereas the values of axial kurtosis (Ka), fractional anisotropy of kurtosis (FAk), hepatic blood volume (HBV), hepatic blood flow (HBF), and hepatic artery perfusion (HAP) were notably decreased (p < 0.05). There were no significant changes regarding FA, radial kurtosis (Kr), mean kurtosis (MK), hepatic arterial fracture (HAF), permeability-surface area product (PS), mean transit time (MTT), and portal vein perfusion (PVP) (p > 0.05). The differences in apparent diffusion coefficients (ADCs) of different liver cancer tissues in patients under different b values after operation were statistically significant, and the ADC values of liver cancer tissues were evidently higher than those of other tumor tissues (p < 0.05).

Conclusion

DKI is characterized with advantages such as fastness, simpleness, high resolution, and impregnability of the density of lipiodol. It can not only directly reflect the changes in blood perfusion at the lesion but also accurately and efficiently evaluate the remnants, necrosis, and recurrence of tumor tissues based on changes in ADC under different b values. It provides certain clinical assistance for the evaluation of the efficacy before and after TACE.