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Clinical Article
Application value of DKI in distinguishing recurrence and pseudoprogression of glioma
DANG Pei  WANG Lidong  HUANG Xueying  LIU Jingjing  LÜ Ruirui  YANG Zhihua  WANG Xiaodong 

Cite this article as: Dang P, Wang LD, Huang XY, et al. Application value of DKI in distinguishing recurrence and pseudoprogression of glioma[J]. Chin J Magn Reson Imaging, 2022, 13(5): 28-33. DOI:10.12015/issn.1674-8034.2022.05.006.

[Abstract] Objective To investigate the value of DKI technology in differentiating glioma recurrence and pseudoprogression in clinical.Materials and Methods Retrospectively collect of 40 patients with glioma who underwent surgery, radiotherapy, chemotherapy and DKI scanning from October 2018 to December 2020 in the General Hospital of Ningxia Medical university. Patients was divided into the recurrence group (24 cases) and the pseudoprogression group (16 cases) by pathology or enhanced MRI scan followed up for more than 6 months. Data were compared by independent samples t-test, Mann-Whitney U-test and receiver operating characteristic to compare the DKI parameter values in enhancing lesions and peritumoral edema in the two groups of patients: Mean kurtosis (MK), mean diffusivity (MD), radial kurtosis (RK), axial kurtosis, fractional anisotropy. Using patient gression free survival (PFS) as the observation end point for events, cox proportional hazards model was used for multivariate analysis.Results Compared with the pseudoprogressive group, the ratio of MK (rMK) and ratio of RK (rRK) of the enhanced lesions in the recurrence group were increased, and ratio of MD (rMD) was decreased (P<0.05). The AUCs of rMK, rRK, and rMD were 0.94, 0.83, and 0.70, respectively (P<0.05). Compared with the pseudoprogressive group, the rMK of peritumoral edema was increased in the recurrence group and rMD was decreased (P<0.05). The area under the ROC curve of rMK and rMD were 0.82, 0.73, respectively (P<0.05). Involvement of the subventricular zone, rMK, rRK and rMD in enhanced lesions and rMK, rMD in peritumoral edema were correlated with PFS (P<0.05).Conclusions DKI can be used to distinguish recurrence and pseudoprogression of glioma, and the parameter value MK can be used as a better imaging marker, the MK value of enhancing lesions is an independent risk factor for PFS.
[Keywords] glioma;recurrence;pseudoprogression;diffusion kurtosis imaging;magnetic resonance imaging;peritumoral edema

DANG Pei1   WANG Lidong2   HUANG Xueying1   LIU Jingjing3   LÜ Ruirui4   YANG Zhihua5   WANG Xiaodong1*  

1 Department of Radiology, General Hospital of Ningxia Medical University, Yinchuan 750004, China

2 Department of Radiology, Yinchuan Traditional Chinese Medicine Hospital, Yinchuan 750001, China

3 Department of Radiology,Xi'an Chest Hospital,Xi'an 710061, China

4 Ningxia Medical University School of Clinical Medicine, Yinchuan 750004, China

5 Department of Radiotherapy, General Hospital of Ningxia Medical University, Yinchuan 750004, China

Wang XD, E-mail:

Conflicts of interest   None.

ACKNOWLEDGMENTS Key Research and Development Plans of Ningxia Hui Autonomous Region (2019BEG03037).
Received  2021-12-17
Accepted  2022-04-01
DOI: 10.12015/issn.1674-8034.2022.05.006
Cite this article as: Dang P, Wang LD, Huang XY, et al. Application value of DKI in distinguishing recurrence and pseudoprogression of glioma[J]. Chin J Magn Reson Imaging, 2022, 13(5): 28-33. DOI:10.12015/issn.1674-8034.2022.05.006.

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