European Radiology

, Volume 27, Issue 5, pp 1848–1857 | Cite as

The value of diffusion kurtosis magnetic resonance imaging for assessing treatment response of neoadjuvant chemoradiotherapy in locally advanced rectal cancer

  • Jing Yu
  • Qing Xu
  • Jia-Cheng Song
  • Yan Li
  • Xin Dai
  • Dong-Ya Huang
  • Ling Zhang
  • Yang Li
  • Hai-Bin ShiEmail author



To evaluate the feasibility and value of diffusion kurtosis (DK) imaging in assessing treatment response to neoadjuvant chemoradiotherapy (CRT) in patients with locally advanced rectal cancer (LARC).


Forty-one patients were included. All patients underwent pre- and post-CRT DCE-MRI on a 3.0-Tesla MRI scanner. Imaging indices (D app , K app and ADC values) were measured. Change value (∆X) and change ratio (r∆X) were calculated. Pathological tumour regression grade scores (Mandard) were the standard reference (good responders: pTRG 1-2; poor responders: pTRG 3-5). Diagnostic performance was compared using ROC analysis.


For the pre-CRT measurements, pre-D app-10th was significantly lower in the good responder group than that of the poor responder group (p = 0.036). For assessing treatment response to neoadjuvant CRT, pre-D app-10th resulted in AUCs of 0.753 (p = 0.036) with a sensitivity of 66.67 % and a specificity of 77.78 %. The rD app had a relatively high AUC (0.859) and high sensitivity (100 %) compared with other image indices.


DKI is feasible for selecting good responders for neoadjuvant CRT for LARC.

Key Points

LARC responded well after neoadjuvant chemoradiotherapy with lower pre-D app-10th .

LARC responded well with greater increases in mean ADC and D app .

The change ratio of D app (r∆D app ) had a relatively better diagnostic performance.


Locally advanced rectal cancer Neoadjuvant chemoradiotherapy Diffusion kurtosis imaging Dapp ADC 



Apparent diffusion coefficient




Apparent diffusion for Gaussian distribution


Diffusion kurtosis imaging


Apparent kurtosis coefficient


Locally advanced rectal cancer


MRI tumour regression grade


Pathological tumour regression grade


Receiver operating characteristic



The scientific guarantor of this publication is Hai-Bin Shi. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional Review Board approval was obtained. Written informed consent was waived by the Institutional Review Board. Methodology: retrospective, observational, performed at one institution.

Supplementary material

330_2016_4529_MOESM1_ESM.docx (15 kb)
ESM 1 (DOCX 14 kb)
330_2016_4529_MOESM2_ESM.docx (16 kb)
ESM 2 (DOCX 16 kb)


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Copyright information

© European Society of Radiology 2016

Authors and Affiliations

  • Jing Yu
    • 1
  • Qing Xu
    • 1
  • Jia-Cheng Song
    • 1
  • Yan Li
    • 1
  • Xin Dai
    • 1
  • Dong-Ya Huang
    • 2
  • Ling Zhang
    • 1
  • Yang Li
    • 3
  • Hai-Bin Shi
    • 1
    Email author
  1. 1.Department of RadiologyFirst Affiliated Hospital of Nanjing Medical UniversityNanjingChina
  2. 2.Department of General SurgeryFirst Affiliated Hospital of Nanjing Medical UniversityNanjingChina
  3. 3.Department of PathologyFirst Affiliated Hospital of Nanjing Medical UniversityNanjingChina

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