Skip to main content

Advertisement

SpringerLink
Log in

Synthetic phase-sensitive inversion-recovery vessel for assessing extramural venous invasion in patients with rectal cancer: imaging quality and added value to T2-wighted imaging

  • Magnetic Resonance
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To evaluate the imaging quality of a synthetic phase-sensitive inversion recovery (SyPSIR) vessel and to add value to T2-weighted imaging (T2WI) for extramural venous invasion (EMVI) detection in patients with rectal cancer.

Methods

Participants in this retrospective study underwent preoperative synthetic MRI between October 2020 and April 2022. SyPSIR image reconstruction was performed with a single inversion time of 10 ms. A junior and a senior radiologist evaluated the imaging quality, including overall imaging quality scores, motion artifact scores, and relative image signal intensity contrast between the tumor and peritumoral vessels (SItumor-vessel), of both T2WI and SyPSIR vessels. Differences in imaging quality between the two methods were assessed using the Wilcoxon signed-rank test and two-sample t-test. EMVI scores were recorded for T2WI and T2WI+SyPSIR vessel. The area under the receiver operating characteristic curve (AUC) was calculated to evaluate the diagnostic performance.

Results

A total of 106 patients (35 EMVI+ and 71 EMVI−) were evaluated. There were no statistically significant differences in the overall image quality scores, motion artifacts, or SItumor-vessel (p = 0.08–0.93) between the T2WI and SyPSIR vessels. On combining T2WI and SyPSIR vessels, the AUC for pathological EMVI+ diagnoses increased from 0.65 to 0.88 for the junior radiologist and from 0.86 to 0.96 for the senior radiologist. Furthermore, the sensitivity of the analyses by junior and senior radiologists increased from 0.40 to 0.77 and 0.49 to 0.86, respectively.

Conclusion

A SyPSIR vessel can provide additional information to improve the diagnostic efficiency of pathological EMVI in rectal cancer, which may be beneficial for individualized clinical treatment.

Key Points

• SyPSIR vessel and T2WI had similar imaging quality.

• EMVI evaluation in SyPSIR vessel has a high inter-observer agreement.

• The SyPSIR vessel has the potential to improve the diagnostic efficiency of EMVI detection in rectal cancer.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

Abbreviations

ADC:

Apparent diffusion coefficient

AUC:

The area of the receiver operating curve

EMVI:

Extramural venous invasion

EMVI-:

Negative EMVI

EMVI+:

Positive EMVI

ICC:

Intraclass correlation coefficient

MAGiC:

Magnetic resonance imaging compilation

pEMVI:

Pathological EMVI

PSIR:

Phase-sensitive inversion recovery

SI:

Signal intensity

SyPSIR:

synthetic phase sensitivity inversion recovery

SyT2WI:

Synthetic T2WI

T2WI:

T2-weighted imaging

References

  1. Arnold M, Sierra MS, Laversanne M et al (2017) Global patterns and trends in colorectal cancer incidence and mortality. Gut 66:683–691

    Article  PubMed  Google Scholar 

  2. Benson AB III, Venook AP, Al-Hawary MM et al (2018) Rectal cancer, version 2.2018, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw 16:874–901

    Article  PubMed  Google Scholar 

  3. Chand M, Bhangu A, Wotherspoon A et al (2014) EMVI-positive stage II rectal cancer has similar clinical outcomes as stage III disease following pre-operative chemoradiotherapy. Ann Oncol 25:858–863

    Article  CAS  PubMed  Google Scholar 

  4. Zhang XY, Wang S, Li XT et al (2018) MRI of extramural venous invasion in locally advanced rectal cancer: relationship to tumor recurrence and overall survival. Radiology 289:677–685

    Article  PubMed  Google Scholar 

  5. Jhaveri KS, Hosseini-Nik H, Thipphavong S et al (2016) MRI detection of extramural venous invasion in rectal cancer: correlation with histopathology using elastin stain. AJR Am J Roentgenol 206:747–755

    Article  PubMed  Google Scholar 

  6. Bae JS, Kim SH, Hur BY et al (2019) Prognostic value of MRI in assessing extramural venous invasion in rectal cancer: multi-readers’ diagnostic performance. Eur Radiol 29:4379–4388

    Article  PubMed  Google Scholar 

  7. Wang S, Li XT, Zhang XY et al (2019) MRI evaluation of extramural vascular invasion by inexperienced radiologists. Br J Radiol 92:20181055

    Article  PubMed  PubMed Central  Google Scholar 

  8. Ahn JH, Kim SH, Son JH, Jo SJ (2019) Added value of diffusion-weighted imaging for evaluation of extramural venous invasion in patients with primary rectal cancer. Br J Radiol 92:20180821

    Article  PubMed  PubMed Central  Google Scholar 

  9. Zhao L, Liang M, Wu PY, Yang Y, Zhang H, Zhao X (2021) A preliminary study of synthetic magnetic resonance imaging in rectal cancer: imaging quality and preoperative assessment. Insights Imaging 12:120

    Article  PubMed  PubMed Central  Google Scholar 

  10. Zhao L, Liang M, Xie L, Yang Y, Zhang H, Zhao X (2021) Prediction of pathological prognostic factors of rectal cancer by relaxation maps from synthetic magnetic resonance imaging. Eur J Radiol 138:109658

    Article  PubMed  Google Scholar 

  11. Zhao L, Liang M, Wang S, Yang Y, Zhang H, Zhao X (2021) Preoperative evaluation of extramural venous invasion in rectal cancer using radiomics analysis of relaxation maps from synthetic MRI. Abdom Radiol (NY) 46:3815–3825

    Article  PubMed  Google Scholar 

  12. Hou P, Hasan KM, Sitton CW, Wolinsky JS, Narayana PA (2005) Phase-sensitive T1 inversion recovery imaging: a time-efficient interleaved technique for improved tissue contrast in neuroimaging[J]. AJNR Am J Neuroradiol 26:1432–1438

    PubMed  PubMed Central  Google Scholar 

  13. Fechner A, Savatovsky J, El Methni J et al (2019) A 3T phase-sensitive inversion recovery MRI sequence improves detection of cervical spinal cord lesions and shows active lesions in patients with multiple sclerosis. AJNR Am J Neuroradiol 40:370–375

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Wang Q, Wang G, Sun Q, Sun DH (2021) Application of MAGnetic resonance imaging compilation in acute ischemic stroke. World J Clin Cases 9:10828–10837

    Article  PubMed  PubMed Central  Google Scholar 

  15. Yi J, Lee YH, Song HT, Suh JS (2019) Double-inversion recovery with synthetic magnetic resonance: a pilot study for assessing synovitis of the knee joint compared to contrast-enhanced magnetic resonance imaging. Eur Radiol 29:2573–2580

    Article  PubMed  Google Scholar 

  16. Smith NJ, Shihab O, Arnaout A, Swift RI, Brown G (2008) MRI for detection of extramural vascular invasion in rectal cancer. AJR Am J Roentgenol 191:1517–1522

    Article  PubMed  Google Scholar 

  17. Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33(1):159–174

    Article  CAS  PubMed  Google Scholar 

  18. Ryu KH, Baek HJ, Moon JI et al (2020) Initial clinical experience of synthetic MRI as a routine neuroimaging protocol in daily practice: a single-center study. J Neuroradiol 47:151–160

    Article  PubMed  Google Scholar 

  19. Liu L, Yang L, Jin E, Wang Z, Yang Z (2016) Effect of gadolinium contrast-enhanced T1-weighted magnetic resonance imaging for detecting extramural venous invasion in rectal cancer. Abdom Radiol (NY) 41:1736–1743

    Article  PubMed  Google Scholar 

  20. Fornell-Perez R, Vivas-Escalona V, Aranda-Sanchez J et al (2020) Primary and post-chemoradiotherapy MRI detection of extramural venous invasion in rectal cancer: the role of diffusion-weighted imaging. Radiol Med 125:522–530

    Article  PubMed  Google Scholar 

  21. Zhao L, Liang M, Yang Y, Xie L, Zhang H, Zhao X (2022) The added value of full and reduced field-of-view apparent diffusion coefficient maps for the evaluation of extramural venous invasion in rectal cancer. Abdom Radiol (NY) 47:48–55

    Article  PubMed  Google Scholar 

  22. Shu Z, Mao D, Song Q, Xu Y, Pang P, Zhang Y (2021) Multiparameter MRI-based radiomics for preoperative prediction of extramural venous invasion in rectal cancer. Eur Radiol 32:1002–1013

    Article  PubMed  Google Scholar 

  23. Ge YX, Xu WB, Wang Z et al (2021) Prognostic value of CT radiomics in evaluating lymphovascular invasion in rectal cancer: diagnostic performance based on different volumes of interest. J Xray Sci Technol 29:663–674

    CAS  PubMed  Google Scholar 

  24. Ge YX, Hu SD, Wang Z et al (2021) Feasibility and reproducibility of T2 mapping and DWI for identifying malignant lymph nodes in rectal cancer. Eur Radiol 31:3347–3354

    Article  PubMed  Google Scholar 

  25. Ge Y, Jia Y, Li X, Dou W, Chen Z, Yan G (2022) T2 relaxation time for the early prediction of treatment response to chemoradiation in locally advanced rectal cancer. Insights Imaging 13:113. https://doi.org/10.1186/s13244-022-01254-z

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgments

We thank Ke-wei Wang for helping with the statistical analysis of the data in this paper. We thank Zi Wang, Xin-yi Zhou, and Bo-jian Fei for their contributions to patient treatment data collection. All authors had access to the study data, and reviewed and approved the final manuscript.

Funding

This study was funded by the Wuxi Science and Technology Development Fund (Grant No. Y20212019).

Author information

Author notes

  1. Yuxi Ge and Yanlong Jia are co-first authors and contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, Affiliated Hospital of Jiangnan University, Wuxi, 214000, Jiangsu, China

    Yuxi Ge, Rongping Guan & Shudong Hu

  2. Department of Radiology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China

    Yanlong Jia

  3. Institute of Maternity Diseases, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China

    Yanlong Jia

  4. Beijing University of Chinese Medicine, Beijing, China

    Yunzhi Li

  5. GE Healthcare, MR Research China, Beijing, China

    Jiankun Dai

Authors
  1. Yuxi Ge
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yanlong Jia
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yunzhi Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jiankun Dai
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Rongping Guan
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Shudong Hu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to Rongping Guan or Shudong Hu.

Ethics declarations

Guarantor

The scientific guarantor of this publication is Shu-dong Hu, M.D., Ph.D.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

Ke-wei Wang kindly provided statistical advice for this manuscript.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval institutional

Institutional Review Board approval was obtained.

Methodology

• retrospective

• diagnostic study

• performed at one institution

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ge, Y., Jia, Y., Li, Y. et al. Synthetic phase-sensitive inversion-recovery vessel for assessing extramural venous invasion in patients with rectal cancer: imaging quality and added value to T2-wighted imaging. Eur Radiol 33, 4148–4157 (2023). https://doi.org/10.1007/s00330-022-09344-8

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-022-09344-8

Keywords

Search

Navigation