title: Diffusion kurtosis imaging to assess response to treatment in hypervascular hepatocellular carcinoma.
abstract: OBJECTIVE
  The objective of our study was to compare diffusion kurtosis imaging (DKI) with conventional diffusion-weighted imaging (DWI) for assessing the response to treatment in hypervascular hepatocellular carcinoma (HCC).
  
  
  METHODS
  Sixty-two consecutive patients with treated or untreated hypervascular HCC underwent MRI of the liver including DKI (b values of 0, 100, 500, 1000, 1500, and 2000 s/mm(2)). The mean kurtosis (MK) and apparent diffusion coefficient (ADC) values of the hepatic parenchyma and of the HCCs were computed. The detectability of viable HCC based on MK and ADC values was compared. We also assessed the correlation between Child-Pugh grades and MK or ADC values.
  
  
  RESULTS
  For a total of 112 HCC nodules (viable, n = 63; nonviable, n = 49), the MK value was significantly higher for the viable group (mean ± SD, 0.81 ± 0.11) than for the non-viable group (0.57 ± 0.11) (p < 0.001). The mean ADC value was significantly lower for the viable group (1.44 ± 0.42 × 10(-3) mm(2)/s) than for the nonviable group (1.94 ± 0.52 × 10(-3) mm(2)/s) (p < 0.001). The sensitivity, specificity, and AUC of the ROC curve for the assessment of HCC viability were greater (p < 0.001) using MK (85.7%, 98.0%, and 0.95, respectively; cutoff value = 0.710) than using ADC (79.6%, 68.3%, and 0.77, respectively; cutoff value = 1.535 × 10(-3) mm(2)/s). Although the ADC of hepatic parenchyma was lower in patients with Child-Pugh grade B or C disease than in those with grade A disease (p = 0.02), no significant difference in MK (p = 0.45) was found among the Child-Pugh grades.
  
  
  CONCLUSIONS
  DKI can be a new option for the assessment of posttherapeutic response in HCC.
authors.affiliation: 1 Department of Radiology, Gifu University Hospital, 1-1 Yanagido, 501-1194 Gifu, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Goshima
authors.forename: Masayuki
authors.initials: M
authors.lastname: Kanematsu
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Noda
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kondo
authors.forename: Haruo
authors.initials: H
authors.lastname: Watanabe
authors.forename: Kyongtae T
authors.initials: KT
authors.lastname: Bae
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000473:pathology* / Q000628:therapy; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008113:Liver Neoplasms / Q000473:pathology* / Q000628:therapy; D008297:Male; D009389:Neovascularization, Pathologic / Q000473:pathology* / Q000628:therapy; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
keywords: HCC; MRI; diffusion; hepatocellular carcinoma; kurtosis; liver