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T2*-weighted imaging and diffusion kurtosis imaging (DKI) of rectal cancer: correlation with clinical histopathologic prognostic factors

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Abstract

Purpose

Histopathologic prognostic factors of rectal cancer are closely associated with local recurrence and distant metastasis. We aim to investigate the feasibility of T2*WI in assessment of clinical prognostic factors of rectal cancer, and compare with DKI.

Methods

This retrospective study enrolled 50 out of 205 patients with rectal cancer according to the inclusion criteria. The following parameters were obtained: R2* from T2*WI, mean diffusivity (MDk), mean kurtosis (MK), and mean diffusivity (MDt) from DKI using tensor method. Above parameters were compared by Mann–Whitney U-test or students’ t test. Spearman correlations between different parameters and histopathological prognostic factors were determined. The diagnostic performances of R2* and DKI-derived parameters were analyzed by receiver operating characteristic curves (ROC), separately and jointly.

Results

There were positive correlations between R2* and multiple prognostic factors of rectal cancer such as T category, N category, tumor grade, CEA level, and LVI (P < 0.004). MDk and MDt showed negative correlations with almost all the histopathological prognostic factors except CRM and TIL involvement (P < 0.003). MK correlated positively with the prognostic factors except CA19-9 level and CRM involvement (P < 0.006). The AUC ranges were 0.724–0.950 for R2* and 0.755–0.913 for DKI-derived parameters for differentiation of prognostic factors. However, no significant differences of diagnostic performance were found between T2*WI, DKI, or the combined imaging methods in characterizing rectal cancer.

Conclusion

R2* and DKI-derived parameters were associated with different histopathological prognostic factors, and might act as noninvasive biomarkers for histopathological characterization of rectal cancer.

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Funding

This work was supported by the National Science Fund for Distinguished Young Scholars of China (No. 81925023) and the National Natural Science Foundation of China (No. 82071892).

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Author notes

  1. Shan Hu and Yang Peng contributed equally to this work.

Authors and Affiliations

  1. The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, China

    Shan Hu, Qiushi Wang, Bin Liu, Zaiyi Liu & Changhong Liang

  2. Department of Radiology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, Guangdong, China

    Shan Hu & Changhong Liang

  3. Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, Hubei, People’s Republic of China

    Yang Peng

  4. Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins Medical Institutions, Baltimore, MD, 21287, USA

    Ihab Kamel

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  1. Shan Hu
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Contributions

LCH are the guarantors of integrity of the entire study. HS, PY, LZY helped in the study concepts and design. HS and PY conducted the literature research. HS, PY, and WQS conducted the clinical studies. HS, PY, LB, and WQS conducted the experimental studies and data analysis. LB conducted the statistical analysis. HS and PY prepared and edited the manuscript. IK reviewed and revised the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Changhong Liang.

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The authors declare that they have no conflict of interest.

Ethical approval

This study was conducted retrospectively under the approval of the Ethics Committee of Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences. Written informed consent for participants was waived for this investigation according to the national legislation and the institutional requirements.

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Hu, S., Peng, Y., Wang, Q. et al. T2*-weighted imaging and diffusion kurtosis imaging (DKI) of rectal cancer: correlation with clinical histopathologic prognostic factors. Abdom Radiol 47, 517–529 (2022). https://doi.org/10.1007/s00261-021-03369-1

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