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Utilization of diffusion-weighted derived mathematical models to predict prognostic factors of resectable rectal cancer

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Abstract

Purpose

This study explored models of monoexponential diffusion-weighted imaging (DWI), diffusion kurtosis imaging (DKI), stretched exponential (SEM), fractional-order calculus (FROC), and continuous-time random-walk (CTRW) as diagnostic tools for assessing pathological prognostic factors in patients with resectable rectal cancer (RRC).

Methods

RRC patients who underwent radical surgery were included. The apparent diffusion coefficient (ADC), the mean kurtosis (MK) and mean diffusion (MD) from the DKI model, the distributed diffusion coefficient (DDC) and α from the SEM model, D, β and u from the FROC model, and D, α and β from the CTRW model were assessed.

Results

There were a total of 181 patients. The area under the receiver operating characteristic (ROC) curve (AUC) of CTRW-α for predicting histology type was significantly higher than that of FROC-u (0.780 vs. 0.671, p = 0.043). The AUC of CTRW-α for predicting pT stage was significantly higher than that of FROC-u and ADC (0.786 vs.0.683, p = 0.043; 0.786 vs. 0.682, p = 0.030), the difference in predictive efficacy of FROC-u between ADC and MK was not statistically significant [0.683 vs. 0.682, p = 0.981; 0.683 vs. 0.703, p = 0.720]; the difference between the predictive efficacy of MK and ADC was not statistically significant (p = 0.696). The AUC of CTRW (α + β) (0.781) was significantly higher than that of FROC-u (0.781 vs. 0.625, p = 0.003) in predicting pN stage but not significantly different from that of MK (p = 0.108).

Conclusion

The CTRW and DKI models may serve as imaging biomarkers to predict pathological prognostic factors in RRC patients before surgery.

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Funding

No funding was received for the conduct of this study.

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Author notes

  1. Mi Zhou and Deying Bao have contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, Sichuan Provincial Orthopedic Hospital, Chengdu, China

    Mi Zhou

  2. Department of Radiology, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China

    Deying Bao & Hongyun Huang

  3. Department of MR Scientific Marketing, Siemens Healthineers, Shanghai, 200135, China

    Meining Chen

  4. Department of Radiology, Second Affiliated Hospital of Chongqing University of Medical Sciences, Chongqing, 400010, China

    Wenli Jiang

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  1. Mi Zhou
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Correspondence to Mi Zhou.

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Zhou, M., Bao, D., Huang, H. et al. Utilization of diffusion-weighted derived mathematical models to predict prognostic factors of resectable rectal cancer. Abdom Radiol (2024). https://doi.org/10.1007/s00261-024-04239-2

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