Our objective was to determine the diagnostic accuracy of a free-breathing diffusion-weighted single-shot echo-planar magnetic resonance imaging (FBDW-SSEPI) technique with parallel imaging and high diffusion factor value (b = 1000 s/mm2) in the detection of primary rectal adenocarcinomas. Thirty-one patients (14M and 17F; mean age 67 years) with histopathologically proven primary rectal adenocarcinomas and 31 patients without rectal malignancies (14M and 17F; mean age 63.6 years) were examined with FBDW-SSEPI (repetition time (TR/echo time (TE) 3900/91 ms, gradient strength 45 mT/m, acquisition time 2 min) at 1.5 T using generalized autocalibrating partially parallel acquisitions (GRAPPA, acceleration factor 2) and a b value of 1000 s/mm2. Apparent diffusion coefficients (ADCs) of rectal adenocarcinomas and normal rectal wall were measured. FBDW-SSEPI images were evaluated for tumour detection by 2 readers. Sensitivity, specificity, accuracy and Youden score for rectal adenocarcinoma detection were calculated with their 95% confidence intervals (CI) for ADC value measurement and visual image analysis. Rectal adenocarcinomas had significantly lower ADCs (mean 1.036 × 10−3 ± 0.107 × 10−3 mm2/s; median 1.015 × 10−3 mm2/s; range (0.827–1.239) × 10−3 mm2/s) compared with the rectal wall of control subjects (mean 1.387 × 10−3 ± 0.106 × 10−3 mm2/s; median 1.385 × 10−3 mm2/s; range (1.176–1.612) × 10−3 mm2/s) (p < 0.0001). Using a threshold value ≤ 1.240 × 10−3 mm2/s, all rectal adenocarcinomas were correctly categorized and 100% sensitivity (31/31; 95% CI 95–100%), 94% specificity (31/33; 95% CI 88–100%), 97% accuracy (60/62; 95% CI 92–100%) and Youden index 0.94 were obtained for the diagnosis of rectal adenocarcinoma. FBDW-SSEPI image analysis allowed depiction of all rectal adenocarcinomas but resulted in 2 false-positive findings, yielding 100% sensitivity (31/31; 95% CI 95–100%), 94% specificity (31/33; 95% CI 88–100%), 97% accuracy (60/62; 95% CI 92–100%) and Youden index 0.94 for the diagnosis of primary rectal adenocarcinoma. We can conclude that FBDW-SSEPI using parallel imaging and high b value may be helpful in the detection of primary rectal adenocarcinomas.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.