T staging of rectal cancer: Accuracy of diffusion-weighted imaging compared with T2-weighted imaging on 3.0 tesla MRI

Objective To evaluate the performance of diffusion-weighted imaging (DWI) in the T staging of primary rectal cancer compared with T2-weighted (T2W) fast spin-echo imaging using 3.0 tesla magnetic resonance imaging (MRI). Methods In total, 46 consecutive patients with rectal cancer who underwent MRI examination before surgery were included in the study. The diagnostic accuracy, sensitivity and specificity of DWI and T2W imaging (T2WI) for T staging of the tumors were evaluated, and interobserver agreement between the two radiologists was calculated. Results The diagnostic accuracies of DWI and T2WI for the T staging of rectal cancer were 73.9% and 71.7%, respectively. The sensitivity and specificity of DWI were 90.0% and 88.9% for diagnosing T1 tumors, 64.3% and 87.5% for T2 tumors, 77.8% and 89.3% for T3 tumors and 50.0% and 97.6% for T4 tumors, respectively; while the sensitivity and specificity of T2WI were 80.0% and 91.7% for T1 tumors, 64.3% and 78.1% for T2 tumors, 77.8% and 89.3% for T3 tumors and 50.0% and 100% for T4 tumors, respectively. There were no significant differences in the diagnostic accuracy, sensitivity or specificity between DWI and T2WI no matter what kind of T stage was concerned (P > 0.05). The interobserver agreement was 0.74 for DWI and 0.63 for T2WI. Conclusions DWI can be applied as a useful tool for evaluating the T staging of rectal cancer. The interobserver agreement obtained by using DWI is better than that obtained by using T2WI.