Department of Radiology, Sichuan Provincial Orthopedic Hospital, Chengdu, China.
Department of Radiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China.
Abdom Radiol (NY). 2024 Sep;49(9):3282-3293. doi: 10.1007/s00261-024-04239-2. Epub 2024 May 15.
This study explored models of monoexponential diffusion-weighted imaging (DWI), diffusion kurtosis imaging (DKI), stretched exponential (SEM), fractional-order calculus (FROC), and continuous-time random-walk (CTRW) as diagnostic tools for assessing pathological prognostic factors in patients with resectable rectal cancer (RRC).
RRC patients who underwent radical surgery were included. The apparent diffusion coefficient (ADC), the mean kurtosis (MK) and mean diffusion (MD) from the DKI model, the distributed diffusion coefficient (DDC) and α from the SEM model, D, β and u from the FROC model, and D, α and β from the CTRW model were assessed.
There were a total of 181 patients. The area under the receiver operating characteristic (ROC) curve (AUC) of CTRW-α for predicting histology type was significantly higher than that of FROC-u (0.780 vs. 0.671, p = 0.043). The AUC of CTRW-α for predicting pT stage was significantly higher than that of FROC-u and ADC (0.786 vs.0.683, p = 0.043; 0.786 vs. 0.682, p = 0.030), the difference in predictive efficacy of FROC-u between ADC and MK was not statistically significant [0.683 vs. 0.682, p = 0.981; 0.683 vs. 0.703, p = 0.720]; the difference between the predictive efficacy of MK and ADC was not statistically significant (p = 0.696). The AUC of CTRW (α + β) (0.781) was significantly higher than that of FROC-u (0.781 vs. 0.625, p = 0.003) in predicting pN stage but not significantly different from that of MK (p = 0.108).
The CTRW and DKI models may serve as imaging biomarkers to predict pathological prognostic factors in RRC patients before surgery.
本研究旨在探讨单指数扩散加权成像（DWI）、扩散峰度成像（DKI）、拉伸指数（SEM）、分数阶微积分（FROC）和连续时间随机游走（CTRW）模型作为评估可切除直肠肿瘤（RRC）患者病理预后因素的诊断工具的价值。
纳入接受根治性手术的 RRC 患者。评估表观扩散系数（ADC）、DKI 模型的平均峰度（MK）和平均扩散（MD）、SEM 模型的分布扩散系数（DDC）和α、FROC 模型的 D、β和 u、CTRW 模型的 D、α和β。
共纳入 181 例患者。CTRW-α 预测组织学类型的受试者工作特征曲线（ROC）下面积（AUC）显著高于 FROC-u（0.780 比 0.671，p=0.043）。CTRW-α 预测 pT 分期的 AUC 显著高于 FROC-u 和 ADC（0.786 比 0.683，p=0.043；0.786 比 0.682，p=0.030），FROC-u 与 ADC 之间预测效能的差异无统计学意义[0.683 比 0.682，p=0.981；0.683 比 0.703，p=0.720]，MK 与 ADC 之间预测效能的差异也无统计学意义（p=0.696）。CTRW（α+β）（0.781）预测 pN 分期的 AUC 显著高于 FROC-u（0.781 比 0.625，p=0.003），但与 MK 无显著差异（p=0.108）。
CTRW 和 DKI 模型可作为影像学生物标志物，用于预测 RRC 患者术前的病理预后因素。
