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The usefulness of b value threshold map in the evaluation of rectal adenocarcinoma

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Abstract

Purpose

To investigate the usefulness of b value threshold (bThreshold) map in the evaluation of rectal adenocarcinoma by comparing it with diffusion-weighted images and ADC maps regarding lesion detection and the prediction of pathological features.

Materials and Methods

Thirty-five patients with rectal tumors were enrolled and underwent axial DWI using a 3-Tesla MRI system. Contrast-to-noise ratio (CNR) between the lesions and normal tissues were assessed on the diffusion-weighted images and bThreshold maps. Reproducibility for ADC and bThreshold values were assessed. Significant differences between different groups for pathological prognostic factors were evaluated. Diagnostic performance of ADC and bThreshold values for those factors were assessed.

Results

Reproducibility was excellent for the ADC and bThreshold values (ICC 0.985 and 0.992; CV 3.8% and 4.0%) measurements. The CNR between lesions and normal tissues on bThreshold maps was significantly higher than that on diffusion-weighted images (9.91 ± 5.35 vs. 7.68 ± 3.08, p = 0.012). There were significant differences in the ADC and bThreshold values between different pathologic differentiation degrees and T stages; significant difference was observed in the bThreshold values between the different N stage groups (all p values < 0.050). No significant differences were observed between the ROC curves of ADC and the bThreshold values of rectal lesions for pathologic differentiation and T stage. bThreshold maps showed good diagnostic performance for N stage.

Conclusion

Both ADC and bThreshold values can differentiate between degrees of pathologic differentiation and T1-2 versus T3-4. Potential added advantages however of the bThreshold map include a higher CNR compared with DWI images, thereby improving lesion visualization detection, and better diagnostic performance for end staging than ADC. Thus, the bThreshold map may compliment DWI and ADC to evaluate pathologic features of rectal primary tumors and metastatic lymph nodes.

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Acknowledgements

This work was supported by the National Key Clinical Specialist Construction Programs of China and the Youth Initiative Fund of Second Military Medical University (Grant No. 2018QN05).

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Author notes

  1. Fu Shen and Luguang Chen contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, Changhai Hospital of Shanghai, Second Military Medical University, No. 168 Changhai Road, Shanghai, 200433, China

    Fu Shen, Luguang Chen, Zhihui Li, Haidi Lu, Yukun Chen, Zhen Wang & Jianping Lu

  2. MR Application Development, Siemens Shenzhen Magnetic Resonance Ltd, Shenzhen, China

    Caixia Fu

  3. MR Applications Pre-development, Siemens Healthcare, Erlangen, Germany

    Robert Grimm

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  1. Fu Shen
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CF and XY are employees of Siemens Healthcare (Shenzhen and Shanghai, China, respectively). FS, LC, and JL who are not employees of Siemens Healthcare had control of the data and information submitted for publication.

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Correspondence to Jianping Lu.

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Shen, F., Chen, L., Li, Z. et al. The usefulness of b value threshold map in the evaluation of rectal adenocarcinoma. Abdom Radiol 45, 332–341 (2020). https://doi.org/10.1007/s00261-019-02272-0

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