Quantitative T2*-Weighted Imaging and Reduced Field-of-View Diffusion-Weighted Imaging of Rectal Cancer: Correlation of R2*and Apparent Diffusion Coefficient With Histopathological Prognostic Factors

Purpose: To assess T2*-weighted imaging (T2*WI) and reduced field-of-view diffusion-weighted Imaging (rDWI) derived parameters and their relationships with histopathological factors in patients with rectal cancer. Methods: Fifty-four patients with pathologically-proven rectal cancer underwent preoperative T2*-weighted imaging and rDWI in this retrospective study. R2* values from T2*-weighted imaging and apparent diffusion coefficient (ADC) values from rDWI were compared in terms of different histopathological prognostic factors using student's t-test or Mann-Whitney U-test. The correlations of R2* and ADC with prognostic factors were assessed by Spearman correlation analysis. The diagnostic performances of R2* and ADC were analyzed by receiver operating characteristic curves (ROC) separately and jointly. Results: Significant positive correlation was found between R2*( )values and T stage, lymph node involvement, histological grades, CEA level, the presence of EMVI and tumor deposit (r = 0.374 similar to 0.673, p = 0.000-0.006), with the exception of CA19-9 level, CRM status and tumor involvement in the circumference lumen (TIL). Meanwhile, ADC values negatively correlated with almost all the prognostic factors (r = -0.588 to -0.299, p = 0.000-0.030), except CA19-9 level. The AUC range was 0.724-0.907 for R2* and 0.6740.887 for ADC in discrimination of different prognostic factors. While showing the highest AUC of 0.913 (0.803-1.000) in differentiation of T stage, combination of R2* and ADC with reference to different prognostic factors did not significantly improve the diagnostic performance in comparison with individual R2*/ADC parameter. Conclusions: R2* and ADC were associated with important histopathological prognostic factors of rectal cancer. R2* might act as additional quantitative imaging marker for tumor characterization of rectal cancer.

Automated summary

The study found a positive correlation between R2* values and several histopathological prognostic factors of rectal cancer, while ADC values were negatively correlated with most prognostic factors. R2* and ADC showed a high diagnostic performance in discriminating prognostic factors of rectal cancer.