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The Value of Multiparametric Diffusion-Weighted Imaging in the Preoperative T Staging of Rectal Cancer1Changhai Hospital, Shanghai, China
Synopsis
This study aimed to explore the value of MP-DWI in the preoperative T staging of rectal cancer.
Objective
This study aimed to explore the value of multiparametric diffusion-weighted imaging (MP-DWI) in the preoperative T staging of rectal cancer.Methods
The images and clinical data of 127 patients with rectal cancer who underwent radical resection in our hospital from July 2017 to October 2019 were analyzed retrospectively. Before operation, MP-DWI was performed for each patient. The parameters were calculated based on IVIM (intravoxel incoherent motion) and DKI (diffusion kurtosis imaging) models: ADC (approximate diffusion coefficient), DT (true diffusion coefficient), PF (perfusion fraction), D* (pseudo-diffusion coefficient), Dapp (diffusion coefficient)，Kapp（kurtosis). Patients were categorized into T1-2 (group A, n=39) and T3-4 (group B, n=88) groups according to postoperative pathological T staging. Univariate and multivariate logistic regression were used to evaluate the relationship between multiparametric indicators and T staging, and to find the independent influencing factors and establish a combined model. Receiver operating characteristic (ROC) curves, area under curve (AUC), sensitivity, specificity, cut-off points of each indicator and the combined model were calculated. And the additive net reclassification index (NRI) of each indicator was compared with the combined model.Results
The sample was composed of 127 patients, including 39 cases in T1-2 group and 88 cases in T3-4 group. Univariate logistic regression showed that ADC, Dt, Dapp, Kapp were associated with T staging of rectal cancer(P＜0.05). Multivariate logistic regression showed that Dt（OR=3.277，P=0.042), Dapp（OR=3.778,P=0.041）, Kapp（OR=8.199，P=0.001）, ADC（OR=85.241，P<0.0001）were correlated with T staging. The AUC of ROC curve of the combined model was 0.896, the specificity was 75.79%, and the sensitivity was 87.50%. NRI showed that the diagnostic efficiency of the combined model is better than that of single indicator.Conclusion
The ADC, Dt, Dapp and Kapp of MP-DWI were correlated with T staging of rectal cancer. The combined model was valuable in evaluating of preoperative T staging of rectal cancer.Acknowledgements
None.References
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