Prediction of pathological prognostic factors of rectal cancer by relaxation maps from synthetic magnetic resonance imaging

Li, Zhao; Liang, Meng; Xie, Lizhi; Yang, Yang; Zhang, Hongmei; Zhao, Xinming

doi:10.1016/j.ejrad.2021.109658

Cited by 18 publications

(17 citation statements)

References 25 publications

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“…Our previous study confirmed the value of quantitative relaxation mapping in evaluating prognostic factors of RC, in which the potential of the T2 value for predicting RC nodal staging has been demonstrated [ 17 ]. Some RC patients with micro-nodal involvement may be underestimated as node-negative at initial MRI, so this study focused on these patients.…”

Section: Discussionsupporting

confidence: 76%

“…Additionally, there have been some promising findings of synthetic MRI in various tumors, such as prostate cancer, breast cancer, bone metastasis [ 6 , 15 , 16 ]. Our previous study has proven that quantitative T1 and T2 values generated from synthetic MRI were useful for predicting prognostic factors of RC [ 17 ]. Another study showed that radiomics model based on synthetic MRI could improve the diagnostic performance of extramural venous invasion (EMVI) in rectal cancer [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

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A preliminary study of synthetic magnetic resonance imaging in rectal cancer: imaging quality and preoperative assessment

Liang

Wu³

et al. 2021

Insights Imaging

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Purpose To compare the imaging quality, T stage and extramural venous invasion (EMVI) evaluation between the conventional and synthetic T2-weighted imaging (T2WI), and to investigate the role of quantitative values obtained from synthetic magnetic resonance imaging (MRI) for assessing nodal staging in rectal cancer (RC). Methods Ninety-four patients with pathologically proven RC who underwent rectal MRI examinations including synthetic MRI were retrospectively recruited. The image quality of conventional and synthetic T2WI was compared regarding signal-to-noise ratio (SNR), contrast-to-noise (CNR), sharpness of the lesion edge, lesion conspicuity, absence of motion artifacts, and overall image quality. The accuracy of T stage and EMVI evaluation on conventional and synthetic T2WI were compared using the Mc-Nemar test. The quantitative T1, T2, and PD values were used to predict the nodal staging of MRI-evaluated node-negative RC. Results There were no statistically significant differences between conventional and synthetic T2WI in SNR, CNR, overall image quality, lesion conspicuity, and absence of motion artifacts (p = 0.058–0.978). There were no significant differences in the diagnostic accuracy of T stage and EMVI between conventional and synthetic T2WI from two observers (p = 0.375 and 0.625 for T stage; p = 0.625 and 0.219 for EMVI). The T2 value showed good diagnostic performance for predicting the nodal staging of RC with the area under the receiver operating characteristic, sensitivity, specificity, and accuracy of 0.854, 90.0%, 71.4%, and 80.3%, respectively. Conclusions Synthetic MRI may facilitate preoperative staging and EMVI evaluation of RC by providing synthetic T2WI and quantitative maps in one acquisition.

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Section: Discussionsupporting

confidence: 76%

Section: Introductionmentioning

confidence: 99%

A preliminary study of synthetic magnetic resonance imaging in rectal cancer: imaging quality and preoperative assessment

Liang

Wu³

et al. 2021

Insights Imaging

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“…To date, several studies have confirmed the potential of the PD value for the diagnosis and grading of prostate, bladder, and breast cancers (16,20,24), consistent with our result. However, Zhao et al (23) reported a different result; they compared the PD values of pathological staging by SyMR at 3T and found no significant differences. The small sample size and the unbalanced data distribution may contribute to the different results.…”

Section: Discussionmentioning

confidence: 96%

Diagnostic performance of synthetic magnetic resonance imaging in the prognostic evaluation of rectal cancer

Lian

Liu

et al. 2022

Quant Imaging Med Surg

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Background: Numerous factors are related to the prognosis of rectal cancer, including T stage, N stage, metastasis, extramural venous invasion (EMVI), circumferential resection margin (CRM), and tumor differentiation. However, it is still a challenge to precisely evaluate them before therapy; therefore, we investigate whether synthetic magnetic resonance imaging and apparent diffusion coefficient (ADC) values could help predict the prognostic factors of rectal cancer. Methods: Eighty-seven patients (55 men and 32 women; mean age, 59±11 years) with pathologically confirmed rectal cancer were enrolled. Preoperative quantitative metrics, including T1, T2, proton density (PD), and ADC values, were measured with diffusion-weighted imaging (DWI) acquired by a single-shot echo-planar sequence and synthetic magnetic resonance imaging acquired by a multi-dynamic multi-echo sequence at 3.0 T, in patients with rectal cancer by two radiologists. We evaluated the diagnostic performance of synthetic magnetic resonance imaging using the independent sample t-test or Mann-Whitney U test and receiver operating characteristic (ROC) curve and multivariate logistic regression analyses and compared the area under the ROC curve of quantitative values using the DeLong test. Results: The T2 and PD values showed a significant reduction among patients with poor differentiation and lymph node metastasis in rectal cancer. The area under the ROC curve values of T2 and PD values for predicting magnetic resonance imaging N stage and differentiation were 0.734, 0.682, and 0.673, 0.686, respectively. Moreover, combining T2 and PD values for magnetic resonance imaging N stage slightly improved the area under the ROC curve value of 0.774 (95% CI, 0.673-0.876). In the present study, the ADC and T1 values were not significant in the differentiation or clinical stage of rectal cancer (RC). Conclusions: Quantitative T2 and PD values obtained by synthetic magnetic resonance imaging might be used for evaluating prognostic factors of rectal cancer noninvasively. Furthermore, combining T2 and PD values further improved the diagnostic performance of magnetic resonance imaging N staging in rectal cancer. The ADC and T1 values were not significant in the differentiation or clinical stage of RC.

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“…Firstly, we used parameters of tumor (ROI-1) for quantitative diagnosis, only T2 values were statistically significant for identifying the presence of pEMVI, and T2 values were increased in the EMVI-positive group. The previous study ( 40 ) found that T1 and T2 values of tumor were all useful for predicting prognostic factors of RC. They think highly aggressive RC have lower T1 value and T2 value, which is different from our results, it maybe because of different ROI drawing method.…”

Section: Discussionmentioning

confidence: 96%

“…They think highly aggressive RC have lower T1 value and T2 value, which is different from our results, it maybe because of different ROI drawing method. Meanwhile, Some studies have suggested that poorly differentiated carcinoma ( 40 ) have lower T2 values, and mucinous adenocarcinoma(MA) ( 41 ) have higher T2 values. In this study, mucinous adenocarcinoma was excluded, and most of the tumors were moderately to highly differentiated rectal cancer (only 6 cases were poorly differentiated), and the tumors were mostly glandular components, which may lead to no differences of parameters in the T and N stage.…”

Section: Discussionmentioning

confidence: 99%

The Preoperative Diagnostic Performance of Multi-Parametric Quantitative Assessment in Rectal Carcinoma: A Preliminary Study Using Synthetic Magnetic Resonance Imaging

et al. 2022

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ObjectiveSynthetic MRI (SyMRI) can reconstruct different contrast-weighted images(T1, T2, PD) and has shorter scan time, easier post-processing and better reproducibility. Some studies have shown splendid correlation with conventional mapping techniques and no degradation in the quality of syMRI images compared with conventional MRI. It is crucial to select an individualized treatment plan based on the preoperative images of rectal carcinoma (RC). We tried to explore the feasibility of syMRI on T, N stage and extramural vascular invasion (EMVI) of rectal cancer.Materials and MethodsA total of 100 patients (37 females and 63 males) diagnosed with rectal carcinoma were enrolled. All the patients underwent preoperative pelvic MR examinations including conventional MR sequence and synthetic MRI. Two radiologists evaluated the MRI findings of each rectal carcinoma and EMVI score in consensus. The values for T1, T2 relaxation times and PD value were measured in tumor(ROI-1) and pararectal fat space(ROI-2) and analyzed independently. A receiver operating characteristic (ROC) analysis was performed. Correlations between the T1, T2 and PD values and EMVI score were also evaluated.ResultsCompared with the normal rectal wall, the values of T1 and T2 relaxation times of the tumor were significantly higher (P <0.001). There was no statistically significant difference in the PD value (P >0.05). As for ROI, the ROI of pararectal fat space(ROI-2) had better significance than rectal cancer lesion (ROI-1). T2 value of ROI-1 and T1 value of ROI-2 were higher in the pEMVI positive group than in the negative group (P=0.002 and 0.001) and T1 value of ROI-2 had better performance with an AUC of 0.787, (95% CI:0.693- 0.882). T1 value, T2 value and PD value from ROI-2 were effective for both T and N stage of rectal cancer. High-grade pathological stage had showed higher T1 value (PT stage=0.013,PN stage=0.035), lower T2 value (PT stage=0.025,PN stage=0.034) and lower PD value (PT stage=0.017). We also enrolled the characteristics with P < 0.05 in the combined model which had better diagnostic efficacy. A significant positive correlation was found between the T1 value of pararectal fat space(ROI-2) and EMVI score (r value = 0.519, P<0.001). The T2 value(r=0.213,P=0.049) and PD value(r=0.354,P=0.001) from ROI-1 was correlated with EMVI score. Correlation analysis did not show any significant associations between T2 value of tumor, T2, PD values of pararectal fat space and EMVI scores.ConclusionSynthetic MRI can provide multi-parameter quantitative image maps with a easier measurement and slightly shorter acquisition time compared with conventional MRI. The measurement of multi-parametric quantitative values contributes to diagnosing the tumor and evaluating T stage, N stage and EMVI. It has the potential to be used as a preoperative diagnostic and grading technique in rectal carcinoma.

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Prediction of pathological prognostic factors of rectal cancer by relaxation maps from synthetic magnetic resonance imaging

Cited by 18 publications

References 25 publications

A preliminary study of synthetic magnetic resonance imaging in rectal cancer: imaging quality and preoperative assessment

A preliminary study of synthetic magnetic resonance imaging in rectal cancer: imaging quality and preoperative assessment

Diagnostic performance of synthetic magnetic resonance imaging in the prognostic evaluation of rectal cancer

The Preoperative Diagnostic Performance of Multi-Parametric Quantitative Assessment in Rectal Carcinoma: A Preliminary Study Using Synthetic Magnetic Resonance Imaging

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