title: Diffusion Kurtosis Imaging Study of Rectal Adenocarcinoma Associated with Histopathologic Prognostic Factors: Preliminary Findings.
abstract: Purpose To determine the correlation between diffusion kurtosis imaging (DKI)-derived parameters and prognostic factors for rectal adenocarcinoma. Materials and Methods This study was approved by the local institute review board, and written informed consent was obtained from each patient. Data from 56 patients (median age, 59.5 years; age range, 31-86 years) with rectal adenocarcinoma between April 2014 and September 2015 were involved in this prospective study. DKI (b = 0, 700, 1400, and 2100 sec/mm2) and conventional diffusion-weighted imaging (b = 0, 1000 sec/mm2) were performed. Kurtosis and diffusivity from DKI and apparent diffusion coefficients (ADCs) from diffusion-weighted imaging were measured by two radiologists. Student t test, receiver operating characteristic curves, and Spearman correlation were used for statistical analysis. Results Kurtosis was significantly higher in high-grade than in low-grade rectal adenocarcinomas on the basis of both the number of poorly differentiated clusters (PDCs) (1.136 ± 0.086 vs 0.988 ± 0.060, P < .05) and World Health Organization (WHO) grades (1.103 ± 0.086 [standard deviation] vs 1.034 ± 0.103, P < .05). In PDC grading, the diffusivity and ADC were significantly lower in high-grade tumors than in low-grade tumors (1.187 ± 0.150 vs 1.306 ± 0.129 and 1.020 ± 0.113 vs 1.108 ± 0.097, respectively; P < .05) and showed similar correlations with histologic grades (r = -0.486 and r = -0.406, respectively; P > .05). Compared with both diffusivity and ADC, kurtosis showed significantly higher sensitivity (83.3% [20 of 24] vs 70.8% [17 of 24] and 70.8% [17 of 24], respectively) and specificity (96.8% [31 of 32] vs 84.4% [24 of 32] and 81.3% [26 of 32], respectively). Kurtosis showed a better correlation with PDC grades than with WHO grades (r = 0.797 vs r = 0.293, P < .05). Kurtosis was significantly higher in pN1-2 than in pN0 tumors (1.086 ± 0.103 vs 1.009 ± 0.086, P < .05). Conclusion Kurtosis derived from DKI demonstrated a higher correlation with histologic grades compared with diffusivity and ADC. It also showed better performance in differentiating between high- and low-grade rectal adenocarcinomas and between pN1-2 and pN0 tumors.©RSNA, 2016.
authors.affiliation: From the Departments of Radiology (L.Z., Z.P., W.Y., H.S., L.D., F.Y., H.Z.) and Pathology (Q.M.), Ruijin Hospital affiliated to Shanghai Jiao Tong University of Medicine, No. 197 Ruijin Er Road, Shanghai, China 200025; Siemens Shenzhen Magnetic Resonance, Shenzhen, China (C.F.); and MR Collaboration NE Asia, Siemens Healthcare, Shanghai, China (X.Y.).
authors.forename: Lan
authors.initials: L
authors.lastname: Zhu
authors.affiliation: From the Departments of Radiology (L.Z., Z.P., W.Y., H.S., L.D., F.Y., H.Z.) and Pathology (Q.M.), Ruijin Hospital affiliated to Shanghai Jiao Tong University of Medicine, No. 197 Ruijin Er Road, Shanghai, China 200025; Siemens Shenzhen Magnetic Resonance, Shenzhen, China (C.F.); and MR Collaboration NE Asia, Siemens Healthcare, Shanghai, China (X.Y.).
authors.forename: Zilai
authors.initials: Z
authors.lastname: Pan
authors.affiliation: From the Departments of Radiology (L.Z., Z.P., W.Y., H.S., L.D., F.Y., H.Z.) and Pathology (Q.M.), Ruijin Hospital affiliated to Shanghai Jiao Tong University of Medicine, No. 197 Ruijin Er Road, Shanghai, China 200025; Siemens Shenzhen Magnetic Resonance, Shenzhen, China (C.F.); and MR Collaboration NE Asia, Siemens Healthcare, Shanghai, China (X.Y.).
authors.forename: Qian
authors.initials: Q
authors.lastname: Ma
authors.affiliation: From the Departments of Radiology (L.Z., Z.P., W.Y., H.S., L.D., F.Y., H.Z.) and Pathology (Q.M.), Ruijin Hospital affiliated to Shanghai Jiao Tong University of Medicine, No. 197 Ruijin Er Road, Shanghai, China 200025; Siemens Shenzhen Magnetic Resonance, Shenzhen, China (C.F.); and MR Collaboration NE Asia, Siemens Healthcare, Shanghai, China (X.Y.).
authors.forename: Wenjie
authors.initials: W
authors.lastname: Yang
authors.affiliation: From the Departments of Radiology (L.Z., Z.P., W.Y., H.S., L.D., F.Y., H.Z.) and Pathology (Q.M.), Ruijin Hospital affiliated to Shanghai Jiao Tong University of Medicine, No. 197 Ruijin Er Road, Shanghai, China 200025; Siemens Shenzhen Magnetic Resonance, Shenzhen, China (C.F.); and MR Collaboration NE Asia, Siemens Healthcare, Shanghai, China (X.Y.).
authors.forename: Hongyuan
authors.initials: H
authors.lastname: Shi
authors.affiliation: From the Departments of Radiology (L.Z., Z.P., W.Y., H.S., L.D., F.Y., H.Z.) and Pathology (Q.M.), Ruijin Hospital affiliated to Shanghai Jiao Tong University of Medicine, No. 197 Ruijin Er Road, Shanghai, China 200025; Siemens Shenzhen Magnetic Resonance, Shenzhen, China (C.F.); and MR Collaboration NE Asia, Siemens Healthcare, Shanghai, China (X.Y.).
authors.forename: Caixia
authors.initials: C
authors.lastname: Fu
authors.affiliation: From the Departments of Radiology (L.Z., Z.P., W.Y., H.S., L.D., F.Y., H.Z.) and Pathology (Q.M.), Ruijin Hospital affiliated to Shanghai Jiao Tong University of Medicine, No. 197 Ruijin Er Road, Shanghai, China 200025; Siemens Shenzhen Magnetic Resonance, Shenzhen, China (C.F.); and MR Collaboration NE Asia, Siemens Healthcare, Shanghai, China (X.Y.).
authors.forename: Xu
authors.initials: X
authors.lastname: Yan
authors.affiliation: From the Departments of Radiology (L.Z., Z.P., W.Y., H.S., L.D., F.Y., H.Z.) and Pathology (Q.M.), Ruijin Hospital affiliated to Shanghai Jiao Tong University of Medicine, No. 197 Ruijin Er Road, Shanghai, China 200025; Siemens Shenzhen Magnetic Resonance, Shenzhen, China (C.F.); and MR Collaboration NE Asia, Siemens Healthcare, Shanghai, China (X.Y.).
authors.forename: Lianjun
authors.initials: L
authors.lastname: Du
authors.affiliation: From the Departments of Radiology (L.Z., Z.P., W.Y., H.S., L.D., F.Y., H.Z.) and Pathology (Q.M.), Ruijin Hospital affiliated to Shanghai Jiao Tong University of Medicine, No. 197 Ruijin Er Road, Shanghai, China 200025; Siemens Shenzhen Magnetic Resonance, Shenzhen, China (C.F.); and MR Collaboration NE Asia, Siemens Healthcare, Shanghai, China (X.Y.).
authors.forename: Fuhua
authors.initials: F
authors.lastname: Yan
authors.affiliation: From the Departments of Radiology (L.Z., Z.P., W.Y., H.S., L.D., F.Y., H.Z.) and Pathology (Q.M.), Ruijin Hospital affiliated to Shanghai Jiao Tong University of Medicine, No. 197 Ruijin Er Road, Shanghai, China 200025; Siemens Shenzhen Magnetic Resonance, Shenzhen, China (C.F.); and MR Collaboration NE Asia, Siemens Healthcare, Shanghai, China (X.Y.).
authors.forename: Huan
authors.initials: H
authors.lastname: Zhang
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D012680:Sensitivity and Specificity