Yuan Jie, Wen Qun, Wang Hui, Wang Jiaoyan, Liu Kun, Zhan Songhua, Liu Mengxiao, Gong Zhigang, Tan WenLi
Department of Radiology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Department of Pathology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Front Oncol. 2023 Jul 20;13:1189334. doi: 10.3389/fonc.2023.1189334. eCollection 2023.
This study aimed to explore the value of T1 mapping in assessing the grade and stage of rectal adenocarcinoma and its correlation with tumor tissue composition.
Informed consent was obtained from all rectal cancer patients after approval by the institutional review board. Twenty-four patients (14 women and 10 men; mean age, 64.46 years; range, 35 - 82 years) were enrolled in this prospective study. MRI examinations were performed using 3.0T MR scanner before surgery. HE, immunohistochemical, and masson trichrome-staining was performed on the surgically resected tumors to assess the degree of differentiation, stage, and invasion. Two radiologists independently analyzed native T1 and postcontrast T1 for each lesion, and calculated the extracellular volume (ECV) was calculated from T1 values. Intraclass correlation coefficient (ICC) and Bland-Altman plots were applied to analyze the interobserver agreement of native T1 values and postcontrast T1 values. Student's t-test and one-way analysis of variance (ANOVA) were used to test the differences between T1 mapping parameters and differentiation types, T and N stages, and venous and neural invasion. Pearson correlation coefficients were used to analyze the correlation of T1 mapping extraction parameters with caudal type homeobox 2 (CDX-2), Ki-67 index, and collagen expression.
Both the native and postcontrast T1 values had an excellent interobserver agreement (ICC 0.945 and 0.942, respectively). Postcontrast T1 values indicated significant differences in venous invasion (t=2.497, =0.021) and neural invasion (t=2.254, =0.034). Pearson's correlation analysis showed a significant positive correlation between native T1 values and Ki-67 (r=-0.407, =0.049). There was a significant positive correlation between ECV and collagen expression (r=0.811, =.000) and a significant negative correlation between ECV and CDX-2 (r=-0.465, =0.022) and Ki-67 (r=-0.549, =0.005).
Postcontrast T1 value can be used to assess venous and neural invasion in rectal cancer. ECV measurements based on T1 mapping can be used to identify cells and collagen fibers in rectal cancer.
本研究旨在探讨T1 mapping在评估直肠腺癌分级和分期中的价值及其与肿瘤组织成分的相关性。
在机构审查委员会批准后，获得了所有直肠癌患者的知情同意书。24例患者（14例女性和10例男性；平均年龄64.46岁；范围35 - 82岁）纳入了这项前瞻性研究。术前使用3.0T MR扫描仪进行MRI检查。对手术切除的肿瘤进行HE、免疫组织化学和Masson三色染色，以评估分化程度、分期和侵袭情况。两名放射科医生独立分析每个病变的平扫T1和增强后T1，并根据T1值计算细胞外容积（ECV）。采用组内相关系数（ICC）和Bland-Altman图分析平扫T1值和增强后T1值的观察者间一致性。采用Student's t检验和单因素方差分析（ANOVA）检验T1 mapping参数与分化类型、T和N分期以及静脉和神经侵犯之间的差异。采用Pearson相关系数分析T1 mapping提取参数与尾型同源盒2（CDX-2）、Ki-67指数和胶原蛋白表达的相关性。
平扫和增强后T1值均具有良好的观察者间一致性（ICC分别为0.945和0.942）。增强后T1值在静脉侵犯（t = 2.497，P = 0.021）和神经侵犯（t = 2.254，P = 0.034）方面显示出显著差异。Pearson相关分析显示平扫T1值与Ki-67之间存在显著正相关（r = -0.407，P = 0.049）。ECV与胶原蛋白表达之间存在显著正相关（r = 0.811，P =.000），ECV与CDX-2（r = -0.465，P = 0.022）和Ki-67（r = -0.549，P = 0.005）之间存在显著负相关。
增强后T1值可用于评估直肠癌的静脉和神经侵犯。基于T1 mapping的ECV测量可用于识别直肠癌中的细胞和胶原纤维。
