MK Values Research Articles

The diagnostic accuracy of intravoxel incoherent motion and diffusion kurtosis imaging in the differentiation of malignant and benign soft-tissue masses: which is better?

It is difficult for conventional magnetic resonance imaging (MRI) to distinguish benign soft-tissue masses (STMs) from malignant masses. To quantitatively compare the diagnostic value of intravoxel incoherent motion (IVIM) and diffusion kurtosis imaging (DKI) in STMs. The data from 58 patients with STMs were retrospectively analyzed. The GE Discovery 3.0-T MRI scanner was used to acquire conventional MRI sequences, IVIM, and DKI images. The chi-square test, independent sample t-test, and Mann-Whitney U tests were used to compare the differences between conventional MRI features, IVIM, and DKI parameters (Dslow, Dfast, f, mean kurtosis [MK], and mean diffusivity [MD]) between the benign and malignant groups. Receiver-operating characteristic (ROC) curve analysis was also performed. Tumor size and depth are statistically different in STTs. Dslow, MK, and MD values in the malignant groups are significantly lower than the benign groups (P < 0.05). However, Dfast and f values are not statistically different between the two groups. The area under the curve (AUC) of Dslow value (0.859) is higher than MD (0.765) and MK (0.676) values for identifying benign and malignant STMs. The Dslow value showed the best specificity (82.93%). The sensitivity and specificity of IVIM and DKI parameters are higher than that of conventional MRI sequences. IVIM and DKI can be used to distinguish between benign and malignant STMs, with Dslow as the most meaningful parameter.

Melting process and melt structure of fly ash/magnesium slag blends for the production of inorganic fibers

Fiber production from inorganic industrial solid wastes is an effective waste management strategy. Because of cost considerations, most enterprises generally use local solid wastes as raw materials to produce fibers. In this study, we explored the feasibility of producing fibers using fly ash and magnesium slag. The results show that the melting temperature of the blends composed of fly ash, magnesium slag, and a small amount of calcined dolomite first decreased and then increased with an increase in acidity coefficient (Mk) from 1.0 to 2.4. The samples could form a eutectic system in the Mk range of 1.4–1.8, and therefore have a relatively low melting temperature in this Mk range. Fly ash could react with magnesium slag and calcined dolomite to form akermanite, gehlenite-magnesium, and anorthite at temperatures close to the melting temperature; therefore, these crystalline phases were the main reaction products formed in the samples with Mk values lower than 1.80. Anorthite reacted further with some Na-containing and Si-containing spieces to produce labradorite. Thus, the content of anorthite and labradorite rapidly increased and they became the major crystal phases in the blend samples with Mk values greater than 1.80. MAS-NMR spectroscopic analysis revealed that the network structure of the melts depended on the ratio of bridging oxygen to non-bridging oxygen; a high ratio of bridging oxygen to non-bridging oxygen could lead to the formation of a dense network structure in the melt. The blends of fly ash and magnesium slag can be used to produce wool fibers and continuous fibers. In addition, the suitable temperature ranges for the production of both types of fibers were determined. The drawing temperature for continuous fiber production depended on the degree of polymerization and structure of the melt.

Weibull Modulus of Cleavage Fracture Toughness of Ferritic Steels

The ordinary Weibull distribution function has been commonly accepted for empirical characterization of cleavage fracture toughness of nuclear reactor and containment pressure vessel steels. However, this method lacks a fundamental basis. This work adopts the standardized Weibull distribution function to analyze cleavage fracture toughness of ferritic steels measured from different sized fracture mechanics specimens at different temperatures to estimate the Weibull modulus. The toughness data of five different nuclear reactor and containment vessel steels are analyzed. The estimations obtained the Weibull modulus (m) in the range of 1.83 to 2.55 and strong temperature dependence of the threshold cleavage fracture toughness Kmin, as opposed to the constant values of mK = 4 and Kmin = 20 MPam1/2 given in ASTM E1921-19. The goodness of fit test by the one-sample Kolmogorov–Smirnov (K–S) test validated Weibull distribution function for describing the toughness distribution.

Heterogeneity of multiple sclerosis lesions in fast diffusional kurtosis imaging.

Mean kurtosis (MK), one of the parameters derived from diffusion kurtosis imaging (DKI), has shown increased sensitivity to tissue microstructure damage in several neurological disorders. Thirty-seven patients with relapsing-remitting MS and eleven healthy controls (HC) received brain imaging on a 3T MR scanner, including a fast DKI sequence. MK and mean diffusivity (MD) were measured in the white matter of HC, normal-appearing white matter (NAWM) of MS patients, contrast-enhancing lesions (CE-L), FLAIR lesions (FLAIR-L) and black holes (BH). Overall 1529 lesions were analyzed, including 30 CE-L, 832 FLAIR-L and 667 BH. Highest MK values were obtained in the white matter of HC (0.814 ± 0.129), followed by NAWM (0.724 ± 0.137), CE-L (0.619 ± 0.096), FLAIR-L (0.565 ± 0.123) and BH (0.549 ± 0.12). Lowest MD values were obtained in the white matter of HC (0.747 ± 0.068 10-3mm2/sec), followed by NAWM (0.808 ± 0.163 10-3mm2/sec), CE-L (0.853 ± 0.211 10-3mm2/sec), BH (0.957 ± 0.304 10-3mm2/sec) and FLAIR-L (0.976 ± 0.35 10-3mm2/sec). While MK differed significantly between CE-L and non-enhancing lesions, MD did not. MK adds predictive value to differentiate between MS lesions and might provide further information about diffuse white matter injury and lesion microstructure.

Diffusion-Weighted MRI and Diffusion Kurtosis Imaging to Detect RAS Mutation in Colorectal Liver Metastasis.

To detect RAS mutation in colorectal liver metastasis by Diffusion-Weighted Magnetic Resonance Imaging (DWI-MRI) - and Diffusion Kurtosis imaging (DKI)-derived parameters. In total, 106 liver metastasis (60 metastases with RAS mutation) in 52 patients were included in this retrospective study. Diffusion and perfusion parameters were derived by DWI (apparent diffusion coefficient (ADC), basal signal (S0), pseudo-diffusion coefficient (DP), perfusion fraction (FP) and tissue diffusivity (DT)) and DKI data (mean of diffusion coefficient (MD) and mean of diffusional Kurtosis (MK)). Wilcoxon-Mann-Whitney U tests for non-parametric variables and receiver operating characteristic (ROC) analyses were calculated with area under ROC curve (AUC). Moreover, pattern recognition approaches (linear classifier, support vector machine, k-nearest neighbours, decision tree), with features selection methods and a leave-one-out cross validation approach, were considered. A significant discrimination between the group with RAS mutation and the group without RAS mutation was obtained by the standard deviation value of MK (MK STD), by the mean value of MD, and by that of FP. The best results were reached by MK STD with an AUC of 0.80 (sensitivity of 72%, specificity of 85%, accuracy of 79%) using a cut-off of 203.90 × 10-3, and by the mean value of MD with AUC of 0.80 (sensitivity of 84%, specificity of 73%, accuracy of 77%) using a cut-off of 1694.30 mm2/s × 10-6. Considering all extracted features or the predictors obtained by the features selection method (the mean value of S0, the standard deviation value of MK, FP and of DT), the tested pattern recognition approaches did not determine an increase in diagnostic accuracy to detect RAS mutation (AUC of 0.73 and 0.69, respectively). Diffusion-Weighted imaging and Diffusion Kurtosis imaging could be used to detect the RAS mutation in liver metastasis. The standard deviation value of MK and the mean value of MD were the more accurate parameters in the RAS mutation detection, with an AUC of 0.80.

Comparison of diffusion-weighted imaging mono-exponential mode with diffusion kurtosis imaging for predicting pathological grades of clear cell renal cell carcinoma

PurposeTo evaluate the role of diffusion kurtosis imaging (DKI11DKI: diffusion kurtosis imaging.) in the characterization of clear cell renal cell carcinoma (ccRCC22ccRCC: clear cell renal cell carcinoma.) compared with standard diffusion-weighted imaging (DWI33DWI: diffusion-weighted imaging.). Methods89 patients with histologically proven ccRCC were evaluated by DKI and DWI on a 3-T scanner. All ccRCCs were classified as grade 1–4 according to the Fuhrman classification system. The apparent diffusion coefficient (ADC44ADC : apparent diffusion coefficient.), fractional anisotropy (FA55FA: fractional anisotropy.), mean diffusivity (MD66MD: mean diffusivity.), mean kurtosis (MK77MK: mean kurtosis.), axial kurtosis (Ka88Ka: axial kurtosis.) and radial kurtosis (Kr99Kr: radial kurtosis.) values were recorded. The differences in DWI and DKI parameters were evaluated by independent-sample t test and a receiver operating characteristic (ROC1010ROC: receiver operating characteristic.) analysis was performed. The DeLong test was performed to compare the ROCs. ResultsCompared to normal renal parenchyma, ADC and MD values of ccRCC decreased and MK, Ka, and Kr values increased (p < 0.05). ADC and MD values of ccRCC decreased with the increase in pathological grade, while MK, Ka, and Kr values were increased (p < 0.05). ADC could discriminate G1 vs G3, G1 vs G4, G2 vs G3, G2 vs G4, and G3 vs G4 (p < 0.05) except for G1 vs G2 (p > 0.05). Ka and Kr could discriminate G1 vs G2, G1 vs G3, G1 vs G4, G2 vs G4, and G3 vs G4 (p < 0.05) except for G2 vs G3 (p > 0.05). MD and MK could discriminate G1 vs G2, G1 vs G3, G1 vs G4, G2 vs G3, G2 vs G4, and G3 vs G4 (p < 0.05). The AUC of MK was the highest. The DeLong test showed that there were significant differences regarding ROCs between ADC/MK, ADC/Ka, ADC/Kr in grading G1/G2, and ADC/MK, MK/Ka in grading G3/G4 (p < 0.05). ConclusionDKI was superior compared to the mono-exponential mode of DWI in grading ccRCC.

Astrometry and infrared observations of the Mira variable stars AP Lyncis, V837 Herculis, and BX Camelopardalis: Implications for the period–luminosity relation of the Milky Way

Abstract AP Lyn and V837 Her are long-period Mira variable stars in the Milky Way. We performed VLBI Exploration of Radio Astrometry (VERA) phase-referenced observations towards H2O masers associated with AP Lyn and V837 Her. The annual parallaxes of AP Lyn and V837 Her were obtained to be 2.008 ± 0.038 mas and 1.090 ± 0.014 mas, corresponding to distances of 498 ± 10 pc and 917 ± 12 pc, respectively. From our multi-epoch infrared observations using the Kagoshima University 1 m telescope, we derived the mean J-, H-, and K′-band magnitudes of AP Lyn, V837 Her, and an additional long-period Mira variable BX Cam, whose parallax is known. We derived their pulsation periods to be 433 ± 1 d, 520 ± 1 d, and 458 ± 1 d, respectively, using the K′-band light curves. The MK–log P relation of long-period Mira variables seem to be violated by Mira variable stars with larger-than-expected MK values (like OZ Gem) in the Milky Way because of circumstellar extinction leading to an observed dimming effect. AP Lyn, V837 Her, and BX Cam (like OZ Gem) are dimming from the trend to O-rich stars in the Large Magellanic Cloud. This implies that the high metallicity of the Milky Way galaxy increases the opacity of the Mira-type variable stars and strengthens mass loss.

Evaluation of microstructural changes in spinal cord of patients with degenerative cervical myelopathy by diffusion kurtosis imaging and investigate the correlation with JOA score

BackgroundTo explore the feasibility of the metrics of diffusion kurtosis imaging (DKI) for investigations of the microstructural changes of spinal cord injury in patients with degenerative cervical myelopathy (DCM) and the correlation between Japan Orthopaedic Association (JOA) scores and DKI metrics.MethodsFifty-seven patients with DCM and 38 healthy volunteers underwent 3.0 T magnetic resonance (MR) imaging with routine MRI sequences and DKI from echo-planar imaging sequence. Based on the JOA score, DCM patients were divided into four subgroups. DKI metrics of the DCM group and control group were obtained and compared, separately for the white matter (WM) and the gray matter (GM).ResultsThe FA values in WM were significantly lower (P = 0.020) in the DCM group than in the control group. The MK values in GM were lower (P = 0.011) in the DCM group than in the control group. The MD values in WM were significantly higher (P = 0.010) in the DCM group than in the control group. In GM, the JOA score was positively correlated with the MK values (r = 0.768, P < 0.05). In the WM, the JOA score was positively correlated with the FA values (r = 0.612, P < 0.05).ConclusionDKI provides quantitive evaluation to the characters of microstructure of the spinal cord damage in patients with DCM compared to conventional MR. MK values can reflect microstructural abnormalities of gray matter of the cervical spinal cord and provide more information beyond that obtained with routine diffusion metrics. In addition, MK values of GM and FA values of WM may as a be highly sensitive biomarker for the degree of cervical spinal cord damage.

Correlations in hydrochloride drugs with diverse pharmacological activities. Role of N-H…Cl bonds

In this work, the structural and vibrational properties of sixteen hydrochloride/hydrobromide drugs with different pharmacological activities have been compared and analysed in order to find some correlations among their properties and, mainly elucidate the role of N-H•••Cl bonds in them. Here, the properties of ten alkaloids: tropane, gramine, morphine, cocaine, methadone, naloxone, heroin and scopolamine as hydrochloride and hydrobromide including, the psychotropic 2-CB agent; three antihistaminic: diphenhydramine, cyclizine and promethazine and; three antihypertensive tolazoline, clonidine and guanfacine agents have been evaluated. All properties were predicted in gas phase and aqueous solution by using the hybrid B3LYP/6-31G* method and the same were evaluated in functions of their molecular weights. Here, stabilization and solvation energies, dipole moments and volumes in both media, atomic MK charges and bond N-H and N+Cl- lengths, N-H stretching modes of N-HCl bonds of hydrochloride and their cationic species and, frontier orbitals together with global electrophilicity and nucleophilicity descriptors were compared for those sixteen drugs. The results have shown that bonds N+Cl- lengths of all hydrochloride species are higher in solution, as compared with the values in gas phase. Hydrochloride species of alkaloids and antihistaminic agents in both media present higher positive MK values on the N atoms of N-HCl bonds while the species related to antihypertensive agents show higher negative MK values on the N atoms or low positive values. The species of guanfacine presents the higher number of donors and acceptors groups, higher dipole moment value in solution, low bond N-H lengths, higher negative charge on the N atom of N-HCl bond and, higher global electrophilicity index. Hydrochloride species of scopolamine and heroin present the more negative solvation energies while tolazoline the lower value. Hydrochloride species of 2-CB and diphendramine show the higher expansions volumes in solution while the species of naloxone, scopolamine and cocaine evidence volumes contractions in this medium. These studies show that the knowledge of hydration degrees, that is, the number of water molecules that hydrate the hydrochloride species are essential to understand the hydration process of these species in relation to the differences observed in solvation energies, volume variations and dipole moment values.

Diffusion Kurtosis Imaging of Leptin Intervention in Early Hypoxic–Ischemic Brain Edema

The role of leptin in neuroprotection has recently been recognized. However, there are few reports on the use of imaging methods to dynamically evaluate the neuroprotection role of leptin. Diffusion kurtosis imaging (DKI), which is a method used to measure non-Gaussian water diffusion, can reflect the real water diffusion in brain tissues. In this study, a newborn piglet model was used to dynamically evaluate the leptin intervention in early hypoxic–ischemic brain edema via DKI. Thirty-two Yorkshire newborn piglets were divided into three groups: the hypoxic–ischemic encephalopathy (HIE) group, the leptin group, and the control group. DKI scanning was performed at time points of 3, 6, 9, 12, 16, and 24 h after hypoxic–ischemic exposure. After scanning, arterial blood was extracted from all piglets to measure NSE and S100β levels. Then, the brain was completely extracted for pathological examination. In the lesion areas, the MK, Ka, and Kr values in the leptin group were significantly lower than those in the HIE group, the MD, Da, and Dr values showed an opposite trend. The lesion areas in the leptin group were smaller than those of in the HIE group. In addition, the pathological results showed that less cell and organelle injury occurred in the leptin group. Our findings indicate that leptin can effectively reduce hypoxic–ischemic brain edema, and DKI can be more sensitive than conventional diffusivity metrics for visualizing the microstructural changes of HIE. This provides a new clue for the treatment and evaluation of HIE.

Diffusion kurtosis imaging as an imaging biomarker for predicting prognosis of the patients with high-grade gliomas

PurposeTo retrospectively explore the utilization of MR diffusion kurtosis imaging (DKI) in predicting prognosis of the patients with high-grade gliomas. Materials and methodsThirty-three consecutive patients with cerebral gliomas underwent pretreatment DKI and diffusion-weighted imaging examination on a 3.0-T MR scanner. Diffusion parameters, including conventional tensor parameters, kurtosis metrics (mean kurtosis [MK], radial kurtosis [AK], and axial kurtosis [RK]), and minimum apparent diffusion coefficient (minADC), were obtained and normalized to the contralateral normal-appearing white matter. Correlations among each diffusion parameter and overall survival were analyzed by a Spearman method. The diagnostic efficiency of each parameter in predicting survival for patients with high-grade gliomas was assessed by a receiver operating characteristic curve. The favorable prognostic imaging biomarkers were further analyzed by using a Kaplan-Meier method with log-rank test. ResultsIn 33 patients, 17 patients reached overall survival >15 months (long survival group), whereas 16 showed overall survival <15 months (short survival group). Negative correlations between kurtosis metrics (MK, AK, and RK) and overall survival were obtained by using Spearman analysis (r = −0.63, −0.57, and −0.61, respectively, all P < 0.01), whereas minADC was positively correlated with overall survival (r = 0.56, P < 0.01). The kurtosis parameters of the long survival group were significantly lower than that of the short survival group (P < 0.001), while the minADC of the long survival group was significantly higher than that of the short survival group (P = 0.002). Among these diffusion parameters, the optimal cut-off value of MK (0.688) provided the best combination of sensitivity (93.75%) and specificity (76.47%) for differentiation of patients with long survival from those with short survival. High kurtosis metrics and low minADC were significant predictors of poor outcome. (P < 0.05). ConclusionBoth kurtosis metrics and minADC have the potential to predict survival for the patients with high-grade gliomas. The preoperative kurtosis parameters, especially MK, can be taken as a preoperative prognostic biomarker to predict prognosis in patients with high-grade gliomas.

Towards high ductility in magnesium alloys - The role of intergranular deformation

This paper investigates the intergranular deformation behavior and its effect on the overall ductility of a Mg-Gd-Y alloy, using in-situ tension in scanning electron microscopy (SEM) combined with electron backscattered diffraction (EBSD) and digital image correlation (DIC) techniques. At regions surrounding grain boundaries, the majority of activated dislocation slip traces were found to form in pairs across grain boundary, and the basal-to-basal (B-B) slip pair is the dominant type. Strain accommodation around the grain boundary interfaces is affected by both Schmid factor in the adjacent grains and the m’ value between these main slip systems. A mk value was proposed in this paper as the maximum value of the product of the Schmid factor and the m’ value of the adjacent grains to measure strain accommodation around the grain boundary interface, where a higher mk value would mean a larger local strain. It is suggested that the overall ductility of a Mg alloy could be evaluated by measuring its average mk value. As an evidence, the Mg-Gd-Y alloy tubes with higher mk value generally show higher elongations during tensile tests in this study.

The value of diffusion kurtosis imaging in early diagnosis of diabetic nephropathy model in Guangxi Bama mini pig

Objective To investigate the value of diffusion kurtosis imaging (DKI) in diagnosing early diabetic nephropathy. Methods Twelve pigs were divided into the experimental group (7 pigs) and the control group (5 pigs), used the random number table method. The experimental group was fed with high-fat high-sugar diet,and then repeatedly injected small doses (50 mg/kg) of Streptozotocin (STZ) through the ear vein. Meanwhile,the control group was fed with normal diet and injected with the same dose of citric acid-sodium citrate buffer solution.After the type 2 diabetes was established successfully, T1WI, T2WI and DKI sequence imaging were performed every month for 2 pigs from the experimental group and the control group,respectively.Mean kurtosis(MK), axial kurtosis (K∥), radial kurtosis (K⊥), fractional anisotropy (FA) and mean diffusivity(MD) were measured on the pseudo-color map of the post-processing workstation. fasting blood glucose(GLU),insulin (INS),renal function, urine routines and random albumin creatinine ratio(RACR) were measured before MRI scan. Specimens from bilateral kidneys were taken for pathological examination after MRI scan. The paired t test was used to compare the parameter values of the cortex and medulla.Independent sample t test was used tocompare the parameter values of the experimental group and the control group. Results In the experimental group,the MK, FA values of medulla were 0.66±0.07 and 0.19±0.04, the MK, FA values of cortex were 0.60±0.06 and 0.16±0.03.In the control group,the MK, FA values of medulla were 0.59±0.03 and 0.20±0.04, the MK, FA values of cortex were 0.53±0.03 and 0.17±0.04.The MK and FA values of medulla were increased compared with the cortex and the difference were statistically significant (P 0.05). Conclusion DKI sequencehas certain value in the diagnosis of early diabetic nephropathy,and to some extent reveals the pathological change in early diabetic nephropathy. Key words: Diabetic nephropathies; Magnetic resonance imaging; Disease models, animal

Abnormal cerebral microstructures revealed by diffusion kurtosis imaging in amyotrophic lateral sclerosis.

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease in which cerebral structural impairment is a consistent feature. To investigate cerebral microstructural changes in ALS using diffusion kurtosis imaging (DKI) for the first time. Prospective. Eighteen ALS patients and 20 healthy controls. DKI images were obtained by a spin-echo echo-planar imaging sequence on a 3T MRI scanner, with three b-values (0, 1000, and 2000 s/mm2 ) and 64 diffusion encoding directions. The revised ALS Functional Rating Scale (ALSFRS-R) was administered to assess disease severity, and the symptom duration and disease progression rate were also recorded. Voxel-based analysis was applied to examine the alteration of DKI metrics (ie, mean kurtosis metrics [MK], axial kurtosis [AK], and radial kurtosis [RK]) and the conventional diffusion metrics (ie, fractional anisotropy, mean diffusivity, axial diffusivity, and radial diffusivity). Student's t-test, chi-square test, and Pearson correlation analysis. ALS patients showed MK reductions in gray matter areas, including the bilateral precentral gyrus, bilateral paracentral lobule, and left anterior cingulate gyrus; they also showed decreased MK values in white matter (WM) in the bilateral precentral gyrus, bilateral corona radiata, bilateral middle corpus callosum, left occipital lobe, and right superior parietal lobule. The spatial distribution of the regions with reduced RK was similar to those with decreased MK. No significant AK difference was found between groups. The correlation analysis revealed significant associations between DKI metrics and clinical assessments such as ALSFRS-R score and disease duration. Additionally, several WM regions showed between-group differences in conventional diffusion metrics; but the spatial extent was smaller than that with reduced DKI metrics. The reduction in DKI metrics indicates decreased microstructural complexity in ALS, involving both motor-related areas and extramotor regions. DKI metrics can serve as potential biomarkers for assessing disease severity. 2 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2020;51:554-562.

Early stage of diffusional kurtosis imaging and dynamic contrast-enhanced magnetic resonance imaging correlated with long-term neurocognitive function after experimental traumatic brain injury

Development of a reliable biomarker for prognostic monitoring of cognitive impairment after traumatic brain injury (TBI) is of great importance. The aim of the study was to explore the value of early diffusional kurtosis imaging (DKI) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in evaluation of chronic cognitive function after TBI. MRI was performed on TBI and control rats at 7 days post-injury. MRI parameters were measured in bilateral cortex, hippocampus, thalamus and corpus callosum (CC). All the rats underwent Morris water maze (MWM) at 6 months after injury. Immunohistochemistry (IHC) analysis of neuron [NeuN], astroglia [GFAP], microglia [Iba-1], and myelin [MBP] was performed after the MWM test. Our study revealed that, TBI group showed higher volume transfer coefficient (Ktrans) value in ipsilateral cortex (P < 0.0001) and no detectable changes in other regions-of-interest (ROIs), compared with control group. DKI showed higher MK in all ipsilateral ROIs (P < 0.05), higher MD in ipsilateral cortex, hippocampus and CC (P < 0.05 for all) in TBI group. TBI group had worse performance in MWM test at 6 months post-injury(P < 0.05). IHC analysis showed lower NeuN, and higher GFAP and Iba-1 in all ipsilateral ROIs (P < 0.05) in TBI rats. NeuN, and GFAP and Iba-1 correlated significantly with MK value in ipsilateral regions of cortex. The MK value of ipsilateral cortex and CC and Ktrans value of ipsilateral cortex also correlated significantly with time in the target quadrant. Therefore, our study indicated that early DKI and DCE-MRI could be used to assess the microstructural changes associated with long-term cognitive outcome following TBI.

MK-curve - Characterizing the relation between mean kurtosis and alterations in the diffusion MRI signal

Diffusion kurtosis imaging (DKI) is a diffusion MRI (dMRI) technique to quantify brain microstructural properties. While DKI measures are sensitive to tissue alterations, they are also affected by signal alterations caused by imaging artifacts such as noise, motion and Gibbs ringing. Consequently, DKI often yields output parameter values (e.g. mean kurtosis; MK) that are implausible. These include implausible values that are outside of the range dictated by physics/biology, and visually apparent implausible values that form unexpected discontinuities, being too high or too low comparing with their neighborhood. These implausible values will introduce bias into any following data analyses (e.g. between-population statistical computation). Existing studies have attempted to correct implausible DKI parameter values in multiple ways; however, these approaches are not always effective. In this study, we propose a novel method for detecting and correcting voxels with implausible values to enable improved DKI parameter estimation. In particular, we focus on MK parameter estimation. We first characterize the relation between MK and alterations in the dMRI signal including diffusion weighted images (DWIs) and the baseline (b0) images. This is done by calculating MK for a range of synthetic DWI or b0 for each voxel, and generating curves (MK-curve) representing how alterations to the input dMRI signals affect the resulting output MK. We find that voxels with implausible MK values are more likely caused by artifacts in the b0 images than artifacts in DWIs with higher b-values. Accordingly, two characteristic b0 values, which define a range of synthetic b0 values that generate implausible MK values, are identified on the MK-curve. Based on this characterization, we propose an automatic approach for detection of voxels with implausible MK values by comparing a voxel's original b0 signal to the identified two characteristic b0 values, along with a correction strategy to replace the original b0 in each detected implausible voxel with a synthetic b0 value computed from the MK-curve. We evaluate the method on a DKI phantom dataset and dMRI datasets from the Human Connectome Project (HCP), and we compare the proposed correction method with other previously proposed correction methods. Results show that our proposed method is able to identify and correct most voxels with implausible DKI parameter values as well as voxels with implausible diffusion tensor parameter values.

Diffusion kurtosis imaging (DKI) of hepatocellular carcinoma: correlation with microvascular invasion and histologic grade.

The aim of this study was to prospectively evaluate the diagnostic efficacy of diffusion kurtosis imaging (DKI) in predicting microvascular invasion (MVI) and histologic grade of hepatocellular carcinoma (HCC) with comparison to the conventional diffusion-weighted imaging (DWI). This prospective study was approved by the Institutional Review Board, and written informed consent was obtained from all patients. From September 2015 to January 2017, 74 consecutive HCC patients were enrolled in this study. Preoperative magnetic resonance imaging including DKI protocol was performed, and patients were followed up for at least one year after surgery. Diffusion parameters including the mean corrected apparent diffusion coefficient (MD), mean apparent kurtosis coefficient (MK), and apparent diffusion coefficient (ADC) were calculated. Differences of diffusion parameters among different histopathological groups were compared. For parameters that were significantly different between pathological groups, receiver operating characteristics (ROC) curve analyses were performed to evaluate the diagnostic efficiency for identifying MVI and predicting high-grade HCC. Univariate and multivariate logistic regression analyses were used to evaluate the relative value of clinical and laboratory variables and diffusion parameters as risk factors for early recurrence (≤1 year). Among all the studied diffusion parameters, only MK differed significantly between the MVI-positive and MVI-negative group (0.91±0.10 vs. 0.82±0.09, P<0.001), and showed moderate diagnostic efficacy (AUC =0.77) for identifying MVI. High-grade HCCs showed significantly higher MK values (0.93±0.10 vs. 0.82±0.09, P<0.001), along with MD (1.34±0.18 vs. 1.54±0.22, P<0.001) and ADC values (1.17±0.15 vs. 1.30±0.16, P=0.001) than low-grade HCCs. For differentiating high-grade from low-grade HCCs, MK demonstrated a higher area under the ROC curve (AUC) and significantly higher specificity than MD and ADC (AUC =0.81 vs. 0.76 and 0.74; specificity =82.2% vs. 60.0% and 60.0%, P=0.02). In addition, higher MK (OR =5.700, P=0.002) and Barcelona Clinic Liver Cancer (BCLC) stage C (OR =6.329, P=0.005) were independent risk factors for early HCC recurrence. DKI-derived MK values outperformed conventional ADC values for predicting MVI and histologic grade of HCC, and are associated with increased risk of early tumor recurrence.

Comparing the value of DKI and DTI in detecting isocitrate dehydrogenase genotype of astrocytomas

To compare the value of diffusion kurtosis imaging (DKI) and diffusion tensor imaging (DTI) in evaluating astrocytomas with an isocitrate dehydrogenase (IDH) genotype. Fifty-eight astrocytomas were divided into IDH-wild-type (IDH-W) and IDH-mutant (IDH-M) groups, in all astrocytomas, low-grade astrocytomas (LGA) and high-grade astrocytomas (HGA), respectively. The DKI (mean kurtosis [MK], radial kurtosis [Kr], axial kurtosis [Ka]), and DTI (fractional anisotropy [FA], mean diffusivity [MD]) values were measured. The differences of parameter values between the IDH-W and IDH-M groups were compared by t-test. Receiver operating characteristic (ROC) curves were used to identify the best parameter and z-score tests were used to compare the performance between DKI and DTI. In all astrocytomas, MK, Ka, and Kr values were significantly higher (p<0.001, p=0.002, and p<0.001), and the MD value (p=0.005) was lower in the IDH-W group than those in the IDH-M group. The areas under the ROC curve (AUC) of MK (0.811) and Kr (0.800) were significantly higher than that of MD (0.704). In LGA, MK, Ka, and Kr values were also significantly higher in the IDH-W group than those in the IDH-M group (p=0.002, p=0.008, p=0.006), whereas MD and FA values showed no differences. In HGA, MK and Kr values were significantly higher (p=0.008, p=0.003), and the MD value (p=0.031) was significantly lower in the IDH-W group than that in the IDH-M group, the AUC of MK (0.750) and Kr (0.788) were also higher than MD (0.637; p=0.032, p=0.025). DKI may be a new imaging biomarker for evaluating the IDH genotype of astrocytomas, which is more accurate and stable than DTI.

Use of diffusion kurtosis imaging and quantitative dynamic contrast-enhanced MRI for the differentiation of breast tumors.

Breast MRI is a sensitive imaging technique to assess breast cancer but its effectiveness still remains to be improved. To evaluate the diagnostic performance of diffusion-weighted imaging (DWI), diffusion kurtosis imaging (DKI), and quantitative dynamic contrast-enhanced (DCE)-MRI in differentiating malignant from benign breast lesions independently or jointly and to explore whether correlations exist among these parameters. Retrospective. In all, 106 patients with breast lesions (47 malignant, 59 benign). DKI sequence with seven b values and quantitative DCE sequence on 3.0T MRI. Diffusion parameters (mean diffusivity [MD], mean diffusivity [MK], and apparent diffusion coefficient [ADC]) from DKI and DWI and perfusion parameters from DCE (Ktrans , kep , ve , and vp ) were calculated by two experienced radiologists after postprocessing. Disagreement between the two observers was resolved by consensus. The parameters in benign and malignant lesions were compared by Student's t-test. The diagnostic performances of DKI and quantitative DCE, either alone or in combination, were evaluated by receiver operating characteristic (ROC) analysis. The Spearman correlation test was used to evaluate correlations among the diffusion parameters and perfusion parameters. MK, MD, ADC, Ktrans , and kep values were significantly different between breast cancer and benign lesions (P < 0.05). MK from DKI demonstrated the highest AUC of 0.849, which is significantly higher than ADC derived from conventional DWI (z = 3.345, P = 0.0008). The specificity of DCE-MRI-derived parameters was improved when combining diffusion parameters, such as ADC and MK. The highest diagnostic specificity (93.2%) was obtained when kep and ADC were combined. kep was correlated moderately positively with MK (r = 0.516) and moderately negatively with MD (r = -0.527). Ktrans was weakly positively correlated with MK with an r of 0.398 and weakly negatively correlated with MD with an r of -0.450. DKI is more valuable than conventional DWI in distinguishing between benign and malignant breast lesions. DKI exhibits promise as a quantitative technique to augment quantitative DCE-MRI. Diffusion parameters derived from DKI were statistically correlated with perfusion parameters from quantitative DCE-MRI. 3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;47:1358-1366.

Comparative study of diffusion kurtosis imaging model and diffusion weighted imaging model in diagnosis of breast cancer

Objective To compare the value of diffusion kurtosis imaging (DKI) model with single-index DWI model parameters in the differential diagnosis of benign and malignant breast lesions, and to explore the correlation between the parameters and molecular subtypes and prognostic factors of breast cancer. Methods A retrospective analysis was performed with inclusion of 64 cases of breast diseases from January 2016 to May 2017 in Shanghai First People's Hospital. The patients were pathologically confirmed and typed, 30 cases are malignant tumors and 34 cases are benign lesions. DKI and DWI were performed within 2 weeks before the pathological examination. Invasive ductal carcinoma of grade Ⅰ, Ⅱ and Ⅲ were revealed in 1, 7 and 13 cases respectively. Luminal A breast cancer was found in 10 cases, Luminal B breast cancer was diagnosed in 11 cases, HER-2 positive breast cancer was 4 cases and triple negative breast cancer was 5 cases. The expressions of estrogen receptor (ER), Progesterone receptor (PR), and HER-2 positive were found in 20, 14 and 15 cases respectively. Ki67 was highly expressed in 24 cases and low expression in 6 cases. All patients underwent both plain and enhanced mammography scanning. The kurtosis (MK), mean diffusivity (MD) and ADC value were measured. Prognosis analysis was performed according to the maximum diameter (>2 cm, ≤2 cm), vascular or neurological invasion (positive, negative), lymph node metastasis (positive, negative), ER (positive, negative), PR (positive, negative), HER-2 (positive, negative), Ki67 (positive, negative), pathological grade (grade Ⅰ+Ⅱ,Ⅲ). Two independent samples t test was used to compare DKI and DWI parameters between benign and malignant lesions. ROC analysis was performed for assessing the values of parameters in discriminating benign and malignant breast lesions. Mann-Whitney U and Kruskal-Wallis H tests were used for the comparison of various prognostic factors or molecular subtypes. Spearman rank correlation analysis was used to explore the correlation of different prognostic factors and DKI and DWI parameters. Results The MK value of malignant group was higher than that of benign group, and the MD value and ADC value were lower than that of benign group (P 0.05). There was a low positive correlation between ER and MK (r= 0.417, P= 0.022). There was no correlation between the other prognostic factors and parameters (r=-0.086 to 0.313, all P>0.05). There was no significant difference in the MD, MK and ADC values among the four different subtypes of breast cancer (all P>0.05). Conclusions MK, MD and ADC values can be used to discriminate benign and malignant breast tumors, among which MK value has the best diagnostic performance. There is a certain correlation between DKI model parameters and prognostic factors. Key words: Breast neoplasms; Magnetic resonance imaging; Diffusion kurtosis imaging