Department of Radiology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, No. 651 Dongfeng East Road, Guangzhou 510060, China.
Central Research Institute, United Imaging Healthcare, Shanghai 201807, China.
Contrast Media Mol Imaging. 2020 Oct 12;2020:2164509. doi: 10.1155/2020/2164509. eCollection 2020.
To combine Intravoxel Incoherent Motions (IVIM) imaging and diffusion kurtosis imaging (DKI) which can aid in the quantification of different biological inspirations including cellularity, vascularity, and microstructural heterogeneity to preoperatively grade rectal cancer.
A total of 58 rectal patients were included into this prospective study. MRI was performed with a 3T scanner. Different combinations of IVIM-derived and DKI-derived parameters were performed to grade rectal cancer. Pearson correlation coefficients were applied to evaluate the correlations. Binary logistic regression models were established via integrating different DWI parameters for screening the most sensitive parameter. Receiver operating characteristic analysis was performed for evaluating the diagnostic performance.
For individual DWI-derived parameters, all parameters except the pseudodiffusion coefficient displayed the capability of grading rectal cancer ( < 0.05). The better discrimination between high- and low-grade rectal cancer was achieved with the combination of different DWI-derived parameters. Similarly, ROC analysis suggested the combination of (true diffusion coefficient), (perfusion fraction), and (apparent kurtosis coefficient) yielded the best diagnostic performance (AUC = 0.953, < 0.001). According to the result of binary logistic analysis, cellularity-related was the most sensitive predictor (odds ratio: 9.350 ± 2.239) for grading rectal cancer.
The combination of IVIM and DKI holds great potential in accurately grading rectal cancer as IVIM and DKI can provide the quantification of different biological inspirations including cellularity, vascularity, and microstructural heterogeneity.
结合体素内不相干运动（IVIM）成像和扩散峰度成像（DKI），可以帮助定量评估包括细胞密度、血管生成和微观结构异质性在内的不同生物学指标，以术前分级直肠癌。
本前瞻性研究共纳入 58 例直肠癌患者。所有患者均在 3T 扫描仪上行 MRI 检查。采用 IVIM 衍生和 DKI 衍生参数的不同组合对直肠癌进行分级。采用 Pearson 相关系数评估相关性。通过整合不同 DWI 参数建立二项逻辑回归模型，筛选最敏感的参数。采用受试者工作特征（ROC）分析评估诊断效能。
对于单个 DWI 衍生参数，除假扩散系数外，所有参数均具有分级直肠癌的能力（ < 0.05）。不同 DWI 衍生参数的组合可更好地区分高低级别直肠癌。同样，ROC 分析表明，不同 DWI 衍生参数的组合（真扩散系数 、灌注分数 、表观峰度系数 ）具有最佳的诊断效能（AUC=0.953， < 0.001）。根据二项逻辑分析的结果，与细胞密度相关的 是分级直肠癌的最敏感预测因子（优势比：9.350±2.239）。
IVIM 和 DKI 的结合具有准确分级直肠癌的巨大潜力，因为 IVIM 和 DKI 可以提供包括细胞密度、血管生成和微观结构异质性在内的不同生物学指标的定量评估。
