Otto Peter Obel, Loft Martina Kastrup, Rafaelsen Søren Rafael, Pedersen Malene Roland Vils
Department of Radiology, University Hospital of Southern Denmark, Beriderbakken 4, 7100 Vejle, Denmark.
Danish Colorectal Cancer Center South, Vejle Hospital, 7100 Vejle, Denmark.
Cancers (Basel). 2023 Dec 27;16(1):144. doi: 10.3390/cancers16010144.
To assess the use of quantitative diffusion-weighted MRI (DW-MRI) as a diagnostic imaging biomarker in differentiating between benign colon adenoma, early, and advanced cancer of the colon, as well as predicting lymph node involvement, and finally comparing mucinous-producing colon cancer with adenomas and non-mucinous colon cancer.
Patients with a confirmed tumor on colonoscopy were eligible for inclusion in this study. Using a 3.0 Tesla MRI machine, the main tumor mean apparent diffusion coefficient (mADC) was obtained. Surgically resected tumor specimens served as an endpoint, except in mucinous colon cancers, which were classified based on T2 images.
A total of 152 patients were included in the study population. The mean age was 71 years. A statistically significant mADC mean difference of -282 × 10 mm/s [-419--144 95% CI, < 0.001] was found between colon adenomas and early colon cancer, with an AUC of 0.80 [0.68-0.93 95% CI] and an optimal cut off value of 1018 × 10 mm/s. Only a small statistically significant difference ( = 0.039) in mADC was found between benign tumors and mucinous colon cancer. We found no statistical difference in mADC mean values between early and advanced colon cancer, and between colon cancer with and without lymph node involvement.
Quantitative DW-MRI is potentially useful for determining whether a colonic tumor is benign or malignant. Mucinous colon cancer shows less diffusion restriction when compared to non-mucinous colon cancer, a potential pitfall.
评估定量扩散加权磁共振成像（DW-MRI）作为一种诊断成像生物标志物在鉴别结肠良性腺瘤、早期和晚期结肠癌，以及预测淋巴结受累情况方面的应用，并最终比较黏液性结肠癌与腺瘤及非黏液性结肠癌。
结肠镜检查确诊有肿瘤的患者符合本研究纳入标准。使用3.0特斯拉磁共振成像仪获取主要肿瘤的平均表观扩散系数（mADC）。手术切除的肿瘤标本作为终点指标，但黏液性结肠癌除外，其根据T2图像进行分类。
研究人群共纳入152例患者。平均年龄为71岁。结肠腺瘤与早期结肠癌之间的mADC平均差异具有统计学意义，为-282×10⁻⁶mm²/s[-419--144，95%CI，P<0.001]，曲线下面积（AUC）为0.80[0.68-0.93，95%CI]，最佳截断值为1018×10⁻⁶mm²/s。良性肿瘤与黏液性结肠癌之间仅发现mADC有微小的统计学差异（P=0.039）。我们发现早期和晚期结肠癌之间，以及有和无淋巴结受累的结肠癌之间，mADC平均值无统计学差异。
定量DW-MRI在确定结肠肿瘤是良性还是恶性方面可能有用。与非黏液性结肠癌相比，黏液性结肠癌的扩散受限程度较小，这是一个潜在的陷阱。
