title: Diagnostic value of dynamic contrast-enhanced magnetic resonance imaging in rectal cancer and its correlation with tumor differentiation.
abstract: Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is a novel imaging modality that can be used to reflect the microcirculation, although its value in diagnosing rectal cancer is unknown. The present study aimed to explore the clinical application of DCE-MRI in the preoperative diagnosis of rectal cancer, and its correlation with tumor differentiation. To achieve this, 40 pathologically confirmed patients with rectal cancer and 15 controls were scanned using DCE-MRI. The Tofts model was applied to obtain the perfusion parameters, including the plasma to extravascular volume transfer (Ktrans), the extravascular to plasma volume transfer (Kep), the extravascular fluid volume (Ve) and the initial area under the enhancement curve (iAUC). Receiver-operating characteristic (ROC) curves were plotted to determine the diagnostic value. The results demonstrated that the time-signal intensity curve of the rectal cancer lesion exhibited an outflow pattern. The Ktrans, Kep, Ve, and iAUC values were higher in the cancer patients compared with controls (P<0.05). The intraclass correlation coefficients of Ktrans, Kep, Ve and iAUC, as measured by two independent radiologists, were 0.991, 0.988, 0.972 and 0.984, respectively (all P<0.001), indicating a good consistency. The areas under the ROC curves for Ktrans and iAUC were both >0.9, resulting in a sensitivity and specificity of 100% and 93.3% for Ktrans, and of 92.5%, and 93.3% or 100%, for iAUC, respectively. In the 40 rectal cancer cases, there was a moderate correlation between Ktrans and iAUC, and pathological differentiation (0.3<r<0.8, all P<0.05). In conclusion, Ktrans and iAUC were associated with the presence of rectal cancer and differentiation, and therefore may provide novel insights into the preoperative diagnosis of rectal cancer.
authors.affiliation: Department of Radiology, Changhai Hospital, Shanghai 200433, P.R. China.
authors.forename: F U
authors.initials: FU
authors.lastname: Shen
authors.affiliation: Department of Radiology, Changhai Hospital, Shanghai 200433, P.R. China.
authors.forename: Jianping
authors.initials: J
authors.lastname: Lu
authors.affiliation: Department of Radiology, Changhai Hospital, Shanghai 200433, P.R. China.
authors.forename: Luguang
authors.initials: L
authors.lastname: Chen
authors.affiliation: Department of Radiology, Changhai Hospital, Shanghai 200433, P.R. China.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Radiology, Changhai Hospital, Shanghai 200433, P.R. China.
authors.forename: Yukun
authors.initials: Y
authors.lastname: Chen
keywords: diagnosis; differentiation; dynamic contrast-enhanced magnetic resonance imaging; rectal cancer; tumor differentiation