T1映射和酰胺质子转移加权成像用于预测直肠癌患者的淋巴结转移
T1 Mapping and Amide Proton Transfer Weighted Imaging for Predicting Lymph Node Metastasis in Patients with Rectal Cancer.
作者信息
Wang Yue, Chen Anliang, Hu Wenjun, Liu Yuhui, Wang Jiazheng, Lin Liangjie, Song Qingwei, Liu Ailian
机构信息
Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, P.R. China, 116011.
Dalian Medical University, Dalian, Liaoning, P.R. China, 116044.
出版信息
Curr Med Imaging. 2024;20:e15734056251952. doi: 10.2174/0115734056251952231012155314.
BACKGROUND
Accurate preoperative judgment of lymph node (LN) metastasis is a critical step in creating a treatment strategy and evaluating prognosis in rectal cancer (RC) patients.
OBJECTIVE
This study aimed to explore the value of T1 mapping and amide proton transfer weighted (APTw) imaging in predicting LN metastasis in patients with rectal cancer.
METHODS
In a retrospective study, twenty-three patients with pathologically confirmed rectal adenocarcinoma who underwent MRI and surgery from August 2019 to August 2021 were selected. Then, 3.0T/MR sequences included conventional sequences (T1WI, T2WI, and DWI), APTw imaging, and T1 mapping. Patients were divided into LN metastasis (group A) and non-LN metastasis groups (group B). The intra-group correlation coefficient (ICC) was used to test the inter-observer consistency. Mann-Whitney U test was used to compare the differences between the two groups. Spearman correlation analysis was performed to evaluate the correlation between T1 and APT values. Logistic regression and receiver operating characteristic (ROC) curve analyses were performed to assess the differential performance of each parameter and their combination. The difference between AUCs was compared using the DeLong test.
RESULTS
The APT value in patients with LN metastasis was significantly higher than in those without LN metastasis group (P=0.020). Also, similar results were observed for the T1 values (P=0.001). The area under the ROC curve of the APT value in the prediction of LN metastasis was 0.794; when the cutoff value was 1.73%, the sensitivity and specificity were 71.4% and 88.9%, respectively. The area under the ROC curve of the T1 value was 0.913; when the cutoff value was 1367.36 ms, the sensitivity and specificity were 78.6% and 100.0%, respectively. The area under the ROC curve of T1+APT was 0.929, with a sensitivity of 78.6% and specificity of 100.0%.
CONCLUSION
APT and T1 values show great diagnostic efficiency in predicting LN metastasis in rectal cancer.
背景
准确的术前淋巴结（LN）转移判断是制定直肠癌（RC）患者治疗策略和评估预后的关键步骤。
目的
本研究旨在探讨T1 mapping和酰胺质子转移加权（APTw）成像在预测直肠癌患者LN转移中的价值。
方法
在一项回顾性研究中，选取2019年8月至2021年8月期间接受MRI检查并手术、病理确诊为直肠腺癌的23例患者。然后，3.0T/MR序列包括常规序列（T1WI、T2WI和DWI）、APTw成像和T1 mapping。患者分为LN转移组（A组）和非LN转移组（B组）。组内相关系数（ICC）用于检验观察者间的一致性。采用Mann-Whitney U检验比较两组间的差异。进行Spearman相关性分析以评估T1值与APT值之间的相关性。进行逻辑回归和受试者工作特征（ROC）曲线分析，以评估各参数及其组合的鉴别性能。使用DeLong检验比较AUC之间的差异。
结果
LN转移患者的APT值显著高于无LN转移组（P = 0.020）。T1值也观察到类似结果（P = 0.001）。APT值预测LN转移的ROC曲线下面积为0.794；当临界值为1.73%时，敏感性和特异性分别为71.4%和88.9%。T1值的ROC曲线下面积为0.913；当临界值为1367.36 ms时，敏感性和特异性分别为78.6%和100.0%。T1 + APT的ROC曲线下面积为0.929，敏感性为78.6%，特异性为100.0%。
结论
APT值和T1值在预测直肠癌LN转移方面显示出很高的诊断效率。
Zotero 插件