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Discriminating rectal cancer grades using restriction spectrum imaging

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Abstract

Purpose

Restriction spectrum imaging (RSI) is a novel diffusion MRI model that separates water diffusion into several microscopic compartments. The restricted compartment correlating to the tumor cellularity is expected to be a potential indicator of rectal cancer aggressiveness. Our aim was to assess the ability of RSI model for rectal tumor grading.

Methods

Fifty-eight patients with different rectal cancer grading confirmed by biopsy were involved in this study. DWI acquisitions were performed using single-shot echo-planar imaging (SS-EPI) with multi-b-values at 3 T. We applied a three-compartment RSI model, along with ADC model and diffusion kurtosis imaging (DKI) model, to DWI images of 58 patients. ROC and AUC were used to compare the performance of the three models in differentiating the low grade (G1 + G2) and high grade (G3). Mean ± standard deviation, ANOVA, ROC analysis, and correlation analysis were used in this study.

Results

The volume fraction of restricted compartment C1 from RSI was significantly correlated with grades (r = 0.403, P = 0.002). It showed significant difference between G1 and G3 (P = 0.008) and between G2 and G3 (P = 0.01). As for the low-grade and high-grade discrimination, significant difference was found in C1 (P < 0.001). The AUC of C1 for differentiation between low-grade and high-grade groups was 0.753 with a sensitivity of 72.0% and a specificity of 70.0%.

Conclusion

The three-compartment RSI model was able to discriminate the rectal cancer of low and high grades. The results outperform the traditional ADC model and DKI model in rectal cancer grading.

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Funding

This research was supported by the National natural Science Foundation of China (Grant Numbers 61901462 and 81801724), the Guangdong Grant Key Technologies for Treatment of Brain Disorders’ (Grant Number 2018B030332001), the Scientific Instrument Innovation Team of the Chinese Academy of Sciences (Grant Number GJJSTD20180002), The International Partnership Program of Chinese Academy of Sciences Grant (Grant Number 154144KYSB20180063), and the Strategic Priority Research Program of Chinese Academy of Sciences (Grant Number XDB25000000).

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    Authors and Affiliations

    1. Paul C. Lauterbur Centre for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China

      Zhongyan Xiong, Xin Liu, Hairong Zheng & Chao Zou

    2. State Key Laboratory of Oncology in Southern China, Department of Radiology, Sun Yat-Sen University Cancer Center, No. 651 Dongfeng East Road, Guangzhou, 510060, China

      Zhijun Geng, Shanshan Lian, Shaohan Yin, Guixiao Xu, Jing Zhao, Lidi Ma & Chuanmiao Xie

    3. Central Research Institute, United Imaging Healthcare, Shanghai, 201807, China

      Yunfei Zhang & Yongming Dai

    4. Key Laboratory for Magnetic Resonance and Multimodality Imaging of Guangdong Province, Shenzhen, 518000, China

      Xin Liu & Chao Zou

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    1. Zhongyan Xiong
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    Correspondence to Chao Zou or Chuanmiao Xie.

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    This retrospective study involving human participants were in accordance with the ethical standards of the Institutional Research Committee and with the 1964 Helsinki Declaration and its later amendments. The Human Investigation Committee (IRB) of Sun Yat-sen University Cancer Center approved this study.

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    Informed consent was obtained from all individual participants included in the study.

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    Zhongyan Xiong, Zhijun Geng, and Shanshan Lian have contributed equally to this work.

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    Xiong, Z., Geng, Z., Lian, S. et al. Discriminating rectal cancer grades using restriction spectrum imaging. Abdom Radiol 47, 2014–2022 (2022). https://doi.org/10.1007/s00261-022-03500-w

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