Prediction of hepatic lymph node metastases based on magnetic resonance imaging before and after preoperative chemotherapy in patients with colorectal liver metastases underwent surgical resection

Zhu, Honglin; Xu, Da; Sun, Xiaofeng; Li, Xiaoting; Zhang, Xiaoyan; Wang, Kun; Xing, Baocai; Sun, Ying‐Shi

doi:10.1186/s40644-023-00529-y

Cited by 2 publications

(1 citation statement)

References 34 publications

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“…We discovered that short diameter of the largest lymph node after treatment were helpful in predicting the status of hepatic lymph node in CRLM patients. This finding is consistent with that of previous study, which indicated that tumor size was an independent predictor of lymph node metastasis [30]. The optimal diagnostic threshold for short diameter of lymph nodes was 10 mm in our study, with sensitivity, specificity and accuracy were 52.5%, 94.7% and 77.3%, respectively.…”

Section: Discussionsupporting

confidence: 93%

Comparison of the Diagnostic Value of Mono-Exponential, Bi-Exponential, and Stretched Exponential Diffusion-Weighted MRI to Predict Hepatic Lymph Node Metastases in Patients with Colorectal Liver Metastases after Chemotherapy

Zhu,

Zhao,

et al. 2023

Preprint

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Colorectal liver metastases (CRLM) patients combined with hepatic lymph node metastases was a negative prognostic factor associated with outcomes. Up to now, there was still lack of a reliable method to identify the status of hepatic lymph nodes. The aim of this study was to investigate the predictive ability of mono-exponential, bi-exponential, and stretched-exponential diffusion-weighted imaging (DWI) models to distinguish between benign and malignant hepatic lymph nodes in CRLM patients who underwent neoadjuvant chemotherapy prior to surgery. In total, 97 CRLM patients with pathologically proved hepatic lymph node status were included. Various quantitative parameters, including the apparent diffusion coefficient (ADC) from mono-exponential model, D, D*, and f derived from intravoxel incoherent motion (IVIM) model, as well as DDC and α from stretched-exponential model (SEM), were measured. Multivariate analysis revealed that the pre- treatment DDC value and the short diameter of the largest lymph node after treatment were independent predictors of metastatic hepatic lymph nodes. A nomogram combining these two factors demonstrated excellent performance in distinguishing between benign and malignant lymph nodes in CRLM patients, with an area under the curve (AUC) of 0.873. Therefore, the nomogram can serve as a preoperative assessment tool for determining the status of hepatic lymph nodes and aiding in the decision-making process for surgical treatment in CRLM patients.

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Section: Discussionsupporting

confidence: 93%

Comparison of the Diagnostic Value of Mono-Exponential, Bi-Exponential, and Stretched Exponential Diffusion-Weighted MRI to Predict Hepatic Lymph Node Metastases in Patients with Colorectal Liver Metastases after Chemotherapy

Zhu,

Zhao,

et al. 2023

Preprint

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Value of multiple models of diffusion-weighted imaging to predict hepatic lymph node metastases in colorectal liver metastases patients

Zhu,

Zhao,

et al. 2024

World J Gastroenterol

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BACKGROUND About 10%-31% of colorectal liver metastases (CRLM) patients would concomitantly show hepatic lymph node metastases (LNM), which was considered as sign of poor biological behavior and a relative contraindication for liver resection. Up to now, there’s still lack of reliable preoperative methods to assess the status of hepatic lymph nodes in patients with CRLM, except for pathology examination of lymph node after resection. AIM To compare the ability of mono-exponential, bi-exponential, and stretched-exponential diffusion-weighted imaging (DWI) models in distinguishing between benign and malignant hepatic lymph nodes in patients with CRLM who received neoadjuvant chemotherapy prior to surgery. METHODS In this retrospective study, 97 CRLM patients with pathologically confirmed hepatic lymph node status underwent magnetic resonance imaging, including DWI with ten b values before and after chemotherapy. Various parameters, such as the apparent diffusion coefficient from the mono-exponential model, and the true diffusion coefficient, the pseudo-diffusion coefficient, and the perfusion fraction derived from the intravoxel incoherent motion model, along with distributed diffusion coefficient (DDC) and α from the stretched-exponential model (SEM), were measured. The parameters before and after chemotherapy were compared between positive and negative hepatic lymph node groups. A nomogram was constructed to predict the hepatic lymph node status. The reliability and agreement of the measurements were assessed using the coefficient of variation and intraclass correlation coefficient. RESULTS Multivariate analysis revealed that the pre-treatment DDC value and the short diameter of the largest lymph node after treatment were independent predictors of metastatic hepatic lymph nodes. A nomogram combining these two factors demonstrated excellent performance in distinguishing between benign and malignant lymph nodes in CRLM patients, with an area under the curve of 0.873. Furthermore, parameters from SEM showed substantial repeatability. CONCLUSION The developed nomogram, incorporating the pre-treatment DDC and the short axis of the largest lymph node, can be used to predict the presence of hepatic LNM in CRLM patients undergoing chemotherapy before surgery. This nomogram was proven to be more valuable, exhibiting superior diagnostic performance compared to quantitative parameters derived from multiple b values of DWI. The nomogram can serve as a preoperative assessment tool for determining the status of hepatic lymph nodes and aiding in the decision-making process for surgical treatment in CRLM patients.

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Prediction of hepatic lymph node metastases based on magnetic resonance imaging before and after preoperative chemotherapy in patients with colorectal liver metastases underwent surgical resection

Cited by 2 publications

References 34 publications

Comparison of the Diagnostic Value of Mono-Exponential, Bi-Exponential, and Stretched Exponential Diffusion-Weighted MRI to Predict Hepatic Lymph Node Metastases in Patients with Colorectal Liver Metastases after Chemotherapy

Comparison of the Diagnostic Value of Mono-Exponential, Bi-Exponential, and Stretched Exponential Diffusion-Weighted MRI to Predict Hepatic Lymph Node Metastases in Patients with Colorectal Liver Metastases after Chemotherapy

Value of multiple models of diffusion-weighted imaging to predict hepatic lymph node metastases in colorectal liver metastases patients

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