Wang Xiao, Liu Wenguang, Masokano Ismail Bilal, Liu Weiyin Vivian, Pei Yigang, Li Wenzheng
Department of Radiology, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, People's Republic of China.
National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, People's Republic of China.
J Imaging Inform Med. 2025 Apr;38(2):946-956. doi: 10.1007/s10278-024-01029-6. Epub 2024 Sep 5.
To investigate the feasibility of predicting rectal adenocarcinoma (RA) tumor (T) and node (N) staging from an optimal ROI measurement using amide proton transfer weighted-signal intensity (APTw-SI) and magnetization transfer (MT) derived from three-dimensional chemical exchange saturation transfer(3D-CEST). Fifty-eight RA patients with pathological TN staging underwent 3D-CEST and DWI. APTw-SI, MT, and ADC values were measured using three ROI approaches (ss-ROI, ts-ROI, and wt-ROI) to analyze the TN staging (T staging, T1-2 vs T3-4; N staging, N - vs N +); the reproducibility of APTw-SI and MT was also evaluated. The AUC was used to assess the staging performance and determine the optimal ROI strategy. MT and APTw-SI yielded good excellent reproducibility with three ROIs, respectively. Significant differences in MT were observed (all P < 0.05) from various ROIs but not in APTw-SI and ADC (all P > 0.05) in the TN stage. AUCs of MT from ss-ROI were 0.860 (95% CI, 0.743-0.937) and 0.852 (95% CI, 0.735-0.932) for predicting T and N staging, which is similar to ts-ROI (T staging, 0.856 [95% CI, 0.739-0.934]; N staging, 0.831 [95% CI, 0.710-0.917]) and wt-ROI (T staging, 0.833 [95% CI, 0.712-0.918]; N staging, 0.848 [95% CI, 0.729-0.929]) (all P > 0.05). MT value of 3D-CEST has excellent TN staging predictive performance in RA patients with all three kinds of ROI methods. The ss-ROI is easy to operate and could be served as the preferred ROI approach for clinical and research applications of 3D-CEST imaging.
为了研究利用三维化学交换饱和转移（3D-CEST）衍生的酰胺质子转移加权信号强度（APTw-SI）和磁化转移（MT）进行最佳感兴趣区（ROI）测量来预测直肠腺癌（RA）肿瘤（T）和淋巴结（N）分期的可行性。58例有病理TN分期的RA患者接受了3D-CEST和扩散加权成像（DWI）检查。使用三种ROI方法（单样本ROI、双样本ROI和全肿瘤ROI）测量APTw-SI、MT和表观扩散系数（ADC）值，以分析TN分期（T分期，T1-2期与T3-4期；N分期，N-期与N+期）；还评估了APTw-SI和MT的可重复性。使用曲线下面积（AUC）评估分期性能并确定最佳ROI策略。MT和APTw-SI分别在三种ROI上具有良好的可重复性。在TN分期中，不同ROI的MT值存在显著差异（所有P<0.05），而APTw-SI和ADC值无显著差异（所有P>0.05）。单样本ROI的MT预测T分期和N分期的AUC分别为0.860（95%置信区间，0.743-0.937）和0.852（95%置信区间，0.735-0.932），与双样本ROI（T分期，0.856[95%置信区间，0.739-0.934]；N分期，0.831[95%置信区间，0.710-0.917]）和全肿瘤ROI（T分期，0.833[95%置信区间，0.712-0.918]；N分期，0.848[95%置信区间，0.729-0.929]）相似（所有P>0.05）。3D-CEST的MT值在所有三种ROI方法的RA患者中均具有出色的TN分期预测性能。单样本ROI操作简便，可作为3D-CEST成像临床和研究应用的首选ROI方法。
