Department of Radiology, Shanxi Province Cancer Hospital, Shanxi Medical University, Taiyuan, 030013, China.
MR Clinical Sciences, Philips Healthcare Greater China, Beijing, China.
Eur Radiol. 2018 Apr;28(4):1485-1494. doi: 10.1007/s00330-017-5094-3. Epub 2017 Oct 23.
To investigate potential relationships between diffusion kurtosis imaging (DKI)-derived parameters using whole-tumour volume histogram analysis and clinicopathological prognostic factors in patients with rectal adenocarcinoma.
79 consecutive patients who underwent MRI examination with rectal adenocarcinoma were retrospectively evaluated. Parameters D, K and conventional ADC were measured using whole-tumour volume histogram analysis. Student's t-test or Mann-Whitney U-test, receiver operating characteristic curves and Spearman's correlation were used for statistical analysis.
Almost all the percentile metrics of K were correlated positively with nodal involvement, higher histological grades, the presence of lymphangiovascular invasion (LVI) and circumferential margin (CRM) (p<0.05), with the exception of between K, K and histological grades. In contrast, significant negative correlations were observed between 25th, 50th percentiles and mean values of ADC and D, as well as ADC, with tumour T stages (p< 0.05). Meanwhile, lower 75th and 90th percentiles of ADC and D values were also correlated inversely with nodal involvement (p< 0.05). K showed a relatively higher area under the curve (AUC) and higher specificity than other percentiles for differentiation of lesions with nodal involvement.
DKI metrics with whole-tumour volume histogram analysis, especially K parameters, were associated with important prognostic factors of rectal cancer.
• K correlated positively with some important prognostic factors of rectal cancer. • K showed higher AUC and specificity for differentiation of nodal involvement. • DKI metrics with whole-tumour volume histogram analysis depicted tumour heterogeneity.
探讨全肿瘤容积直方图分析中扩散峰度成像（DKI）衍生参数与直肠腺癌患者临床病理预后因素之间的潜在关系。
回顾性分析 79 例经 MRI 检查诊断为直肠腺癌的患者。使用全肿瘤容积直方图分析测量参数 D、K 和常规 ADC。采用 Student's t 检验或 Mann-Whitney U 检验、受试者工作特征曲线和 Spearman 相关分析进行统计学分析。
几乎所有 K 的百分位数指标均与淋巴结受累、较高的组织学分级、存在淋巴管血管侵犯（LVI）和环周切缘（CRM）呈正相关（p<0.05），但 K 与组织学分级除外。相反，ADC 和 D 的 25 百分位、50 百分位和平均值，以及 ADC 与肿瘤 T 分期之间存在显著负相关（p<0.05）。同时，ADC 和 D 的较低的 75 百分位和 90 百分位值也与淋巴结受累呈负相关（p<0.05）。K 区分有淋巴结受累的病变时，曲线下面积（AUC）和特异性均较高。
全肿瘤容积直方图分析的 DKI 指标，尤其是 K 参数，与直肠癌的重要预后因素相关。
• K 与直肠癌的一些重要预后因素呈正相关。• K 区分淋巴结受累的 AUC 和特异性较高。• 全肿瘤容积直方图分析的 DKI 指标描绘了肿瘤异质性。
