Diffusion-Weighted Magnetic Resonance Imaging in Liver Graft Rejection.

Area of Science:

• Radiology
• Transplant Surgery
• Medical Imaging

Background:

• Liver transplantation (LT) is a critical procedure for end-stage liver disease.
• Assessing graft rejection is vital for long-term transplant success.
• Non-invasive imaging techniques are sought to monitor graft health.

Purpose of the Study:

• To evaluate the efficacy of diffusion-weighted magnetic resonance imaging (DWMRI) in diagnosing liver graft rejection post-transplantation.
• To determine specific DWMRI parameters that correlate with histopathological findings of rejection.

Main Methods:

• 32 patients undergoing LT were studied between June 2017 and January 2018.
• Diffusion-weighted MRI was performed using apparent diffusion coefficient maps at various b-values (400, 600, 800, 1000).
• DWMRI measurements were statistically compared with histopathology results using t-tests, ANOVA, and ROC analysis.

Main Results:

• Significant differences in DWMRI values were observed between non-rejection and rejection groups at b-600 (P=.039) and b-800 (P=.035).
• b-800 values effectively differentiated between mild, moderate, and severe rejection grades (P<.001).
• Receiver operating characteristic analysis showed high diagnostic performance for b-600 (AUC=0.784) and b-800 (AUC=0.816).

Conclusions:

• DWMRI measurements, particularly at b-600 and b-800 values, show promise for non-invasively diagnosing liver graft rejection.
• These findings suggest DWMRI can be a valuable tool in post-LT graft monitoring.
• Further validation in larger cohorts is warranted to establish DWMRI as a standard diagnostic method.