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Application of intravoxel incoherent motion diffusion-weighted imaging for preoperative knowledge of lymphovascular invasion in gastric cancer: a prospective study

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Abstract

Purpose

To investigate the potential of intravoxel incoherent motion diffusion-weighted imaging (IVIM) for preoperative prediction of lymphovascular invasion (LVI) in gastric cancer (GC).

Methods

This study prospectively enrolled 90 patients (62 males, 28 females, 60.79 ± 9.99 years old) who received radical gastrostomy. Abdominal MRI examinations including IVIM were performed within 1 week before surgery. Patients were divided into LVI-positive and -negative group according to pathological diagnosis after surgery. The apparent diffusion coefficient (ADC) and IVIM parameters, including true diffusion coefficient (D), pseudodiffusion coefficient (D*), and pseudodiffusion fraction (f), were compared between the two groups. The relationship between MRI parameters and LVI was studied by Spearman’s correlation analysis. Multivariable logistic regression analysis was used to screen independent predictors of LVI. Receiver-operating characteristic curve analyses were applied to evaluate the efficacy.

Results

The ADC, D in LVI-positive group were lower, whereas tumor thickness and f parameter in LVI-positive group were higher than those in LVI-negative group, and they were statistically correlated with LVI (p < 0.05). D, f and tumor thickness were independent risk factors of LVI. The area under the curve of ADC, D, f, thickness, and the combined parameter (D + f + thickness) were 0.667, 0.754, 0.695, 0.792, and 0.876, respectively. The combined parameter demonstrated higher efficacy than any other parameters (p < 0.05).

Conclusion

The ADC, D, and f can effectively distinguish LVI status of GC. The D, f and thickness were independent predictors. The combination of the three predictors further improved the efficacy.

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Data availability

The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

This work was supported by [Henan Provincial Medical Science and Technology Project (SBGJ202003011)], [National Natural Science Foundation of China (Nos. 82202146, 82271979)], [Special funding of Henan Health Science and Technology Innovation Talent Project (Nos. YXKC2020011, YXKC2021054)].

Author information

Authors and Affiliations

  1. Department of Radiology, The Affiliated Cancer Hospital of Zhengzhou University (Henan Cancer Hospital), No. 127, Dongming Road, Zhengzhou, 450008, Henan, China

    Jing Li, Liang-liang Yan, Hong-kai Zhang, Xue-jun Chen & Jin-rong Qu

  2. Department of Pathology, The Affiliated Cancer Hospital of Zhengzhou University (Henan Cancer Hospital), No.127, Dongming Road, Zhengzhou, 450008, Henan, China

    Yi Wang

  3. Department of Digestive Oncology, The Affiliated Cancer Hospital of Zhengzhou University (Henan Cancer Hospital), No.127, Dongming Road, Zhengzhou, 450008, Henan, China

    Shu-ning Xu

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Contributions

Conceptualization: JL, JQ; Methodology: HZ, SX; Formal analysis and investigation: JL, LY, YW; Writing—original draft preparation: JL, YW; Writing—review and editing: JQ, XC; Funding acquisition: JL, JQ; Resources: JQ; Supervision: XC. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Jin-rong Qu.

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Competing interests

The authors did not receive support from any organization for the submitted work.

Ethical approval

The study was approved by the institutional review board of the Affiliated Cancer Hospital of Zhengzhou University (Henan Cancer Hospital, Zhengzhou, China) in accordance with the Declaration of Helsinki. All methods were carried out in accordance with relevant guidelines and regulations.

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Written informed consent was obtained from all individual patients included in the study (NCT04028375).

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Li, J., Yan, Ll., Zhang, Hk. et al. Application of intravoxel incoherent motion diffusion-weighted imaging for preoperative knowledge of lymphovascular invasion in gastric cancer: a prospective study. Abdom Radiol 48, 2207–2218 (2023). https://doi.org/10.1007/s00261-023-03920-2

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