Application value of dynamic contrast-enhanced magnetic resonance imaging quantitative parameters and apparent diffusion coefficient value in evaluating differentiation degrees and T stages of rectal cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

GOU Wenxiao ¹ ,  YIN Longlin ² , WANG Kang ³

1. Department of Radiology, Wenjiang Hospital of Sichuan Provincial People’s Hospital·Chengdu Wenjiang District People’s Hospital, Chengdu 611130, P. R. China;
2. Department of Radiology, Sichuan Provincial People’s Hospital, Chengdu 610072, P. R. China;
3. Department of Gastrointestinal Surgery, Sichuan Provincial People’s Hospital, Chengdu 610072, P. R. China;

Corresponding?author：

YIN Longlin, Email: yinlonglin@163.com

Keywords：

rectal cancer; dynamic contrast-enhanced magnetic resonance imaging; quantitative parameters; apparent diffosion coefficient

DOI：

10.7507/1007-9424.202004064

Video：

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Objective To explore the application value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) quantitative parameters and apparent diffusion coefficient (ADC) value in evaluating the differentiation degrees and T stages of rectal cancer.Methods The patients with rectal cancer from November 2017 to November 2019 in the Sichuan Provincial People’s Hospital were collected. The volume transfer constant (K^trans), flux rate constant (K_ep), and extravascular extracellular volume fraction (V_e), and ADC values of the tumors were measured and compared in the patients with the different differentiation degrees and T stages. The receiver operating characteristic (ROC) curve analysis was performed.Results All of 53 eligible patients were included, including 13 cases of high differentiation, 30 cases of medium differentiation, and 10 cases of low differentiation; 5 cases of T1 stage, 8 cases of T2 stage, 24 cases of T3 stage, and 16 cases of T4 stage. ① There were statistical differences in the K^trans and ADC values among the different differentiation degrees of rectal cancer (P=0.004, P<0.001), and no statistical differences in the K_ep and V_e values (P>0.050) among them. The K^trans value was increased with decreased differentiation degree (P<0.050), the ADC value was decreased with decreased differentiation degrees (P<0.050). ② There were statistical differences in the K^trans and ADC values among the different T stages of rectal cancer (P=0.002; P=0.007), and no statistical differences in the K_ep and V_e values (P>0.050) among them. The K^trans and ADC values were statistically different between the T2 and T3 stages of rectal cancer (P=0.009, P=0.013). ③ The K^trans and ADC values could distinguish the high and medium differentiation degrees of rectal cancer, its area under ROC curve (AUC) values were 0.677 and 0.763, respectively, and the corresponding best thresholds were 0.180/min and 1.179 mm²/s; The K^trans and ADC values could distinguish the medium and low differentiation degrees of rectal cancer, its AUC values were 0.693 and 0.967, and the corresponding best thresholds were 0.281/min and 0.906 mm²/s; The K^trans and ADC values could distinguish the T2 and T3 stages of rectal cancer, its AUC values were 0.862 and 0.742, and the corresponding best thresholds were 0.204/min and 1.579 mm²/s.Conclusion DCE-MRI quantitative parameters and ADC value before surgery to determine the different differentiation degrees and T stages of rectal cancer have certain reference value, the best K^trans and ADC thresholds to distinguish different differentiation degrees and T2 to T3 stages can be obtained through statistical analysis.

Citation： GOU Wenxiao, YIN Longlin, WANG Kang. Application value of dynamic contrast-enhanced magnetic resonance imaging quantitative parameters and apparent diffusion coefficient value in evaluating differentiation degrees and T stages of rectal cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2020, 27(7): 884-889. doi: 10.7507/1007-9424.202004064 Copy

1.	孫可欣, 鄭榮壽, 張思維, 等. 2015年中國分地區惡性腫瘤發病和死亡分析. 中國腫瘤, 2019, 28(1): 1-11.
2.	曾煥虹, 傅衛, 孫濤, 等. 腹腔鏡直腸癌根治術后患者的長期生存及其影響因素. 中華普通外科雜志, 2018, 33(1): 25-29.
3.	Sch?fer AO. Local imaging of rectal cancer—update 2015: MRI as imaging biomarker. Radiologe, 2015, 55(11): 1015-1026.
4.	錢海峰, 孫勝杰, 吳曉, 等. 動態對比增強磁共振鑒別高級別腦膠質瘤和單發腦轉移瘤的價值. 實用放射學雜志, 2016, 32(1): 5-9.
5.	高永偉, 牛廣明, 韓曉東. 3.0T磁共振擴散加權成像診斷直腸癌最適b值的選取. 臨床軍醫雜志, 2012, 40(6): 1464-1467.
6.	高欣, 周麗娟, 徐孝秋, 等. 動態增強磁共振成像定量參數直方圖分析與鼻咽癌臨床分期的相關性初步研究. 實用放射學雜志, 2019, 35(10): 1590-1594.
7.	Kim YE, Lim JS, Choi J, et al. Perfusion parameters of dynamic contrast-enhanced magnetic resonance imaging in patients with rectal cancer: correlation with microvascular density and vascular endothelial growth factor expression. Korean J Radiol, 2013, 14(6): 878-885.
8.	沈浮, 陸建平, 陳錄廣, 等. 動態增強磁共振成像與直腸癌分化程度的相關性研究. 放射學實踐, 2015, 30(10): 1031-1035.
9.	唐翠, 續晉銘, 盧曉玲, 等. 不同病理特征直腸癌的MR灌注成像參數分析. 中國醫學影像技術, 2016, 32(10): 1540-1544.
10.	張文文, 黃剛, 周星, 等. DCE-MRI定量參數與直腸癌病理分期及分級的相關性研究. 臨床放射學雜志, 2016, 35(7): 1058-1061.
11.	肖曉娟, 盧寶蘭, 楊心悅, 等. 定量磁共振灌注成像用于評價直腸癌的微血管灌注及滲透性. 中國病理生理雜志, 2015, 31(12): 2164-2168.
12.	宋媛, 丁爽, 賈文霄. DCE-MRI評價腫瘤血管生成的實驗研究. 放射學實踐, 2014, 29(6): 640-643.
13.	聶丹, 黃瑾瑜, 郭亮, 等. 動態增強磁共振定量分析在直腸癌術前診斷中的應用價值. 臨床放射學雜志, 2018, 37(5): 807-811.
14.	謝宗源, 徐香玖, 黃剛, 等. 直腸癌DCE-MRI參數與病理特征的相關性研究. 磁共振成像, 2015, 6(4): 289-293.
15.	Yeo DM, Oh SN, Jung CK, et al. Correlation of dynamic contrast-enhanced MRI perfusion parameters with angiogenesis and biologic aggressiveness of rectal cancer: Preliminary results. J Magn Reson Imaging, 2015, 41(2): 474-480.
16.	Yao WW, Zhang H, Ding B, et al. Rectal cancer: 3D dynamic contrast-enhanced MRI; correlation with microvascular density and clinicopathological features. Radiol Med, 2011, 116(3): 366-374.
17.	Morvan D. In vivo measurement of diffusion and pseudo-diffusion in skeletal muscle at rest and after exercise. Magn Reson Imaging, 1995, 13(2): 193-199.
18.	蔣杰, 曲源, 夏迎洪, 等. 磁共振擴散成像的原理及應用. 新疆醫學, 2011, 41(11): 69-72.
19.	高永偉, 牛廣明, 韓曉東. 3.0T磁共振診斷直腸癌ADC值與腫瘤分化程度的相關性分析. 中國醫療前沿, 2012, 07(6): 7-8.
20.	齊英杰, 張景忠, 楊明俐, 等. MRI擴散加權成像在直腸癌術前診斷中的應用優勢. 臨床放射學雜志, 2019, 38(3): 475-478.
21.	Akashi M, Nakahusa Y, Yakabe T, et al. Assessment of aggressiveness of rectal cancer using 3-T MRI: correlation between the apparent diffusion coefficient as a potential imaging biomarker and histologic prognostic factors. Acta Radiol, 2014, 55(5): 524-531.
22.	Curvo-Semedo L, Lambregts DM, Maas M, et al. Diffusion-weighted MRI in rectal cancer: apparent diffusion coefficient as a potential noninvasive marker of tumor aggressiveness. J Magn Reson Imaging, 2012, 35(6): 1365-1371.
23.	朱麗娜, 顏社平, 盧喜, 等. 不同組織分化類型與臨床分期直腸癌的ADC值研究. 臨床放射學雜志, 2016, 35(5): 746-749.
24.	陸志華, 錢偉新, 曹文洪, 等. 磁共振擴散加權成像對直腸癌T分期的診斷價值. 中華胃腸外科雜志, 2015, 17(3): 257-261.
25.	羅偉, 張亞林, 周理超. 不同b值擴散加權成像對前列腺中央腺體局限性病變良惡性的診斷價值. 實用放射學雜志, 2019, 35(9): 1460-1463, 1475.
26.	陳衛中, 倪宗瓚, 潘曉平, 等. 用ROC曲線確定最佳臨界點和可疑值范圍. 現代預防醫學, 2005, 32(7): 729-731.
27.	杜麗新, 李書清, 李鳳蓮, 等. ROC曲線確定最佳臨界點的方法探討. 標記免疫分析與臨床, 2015, 22(8): 823-824.
28.	王旭斌, 趙媛, 范杰, 等. 應用ROC曲線對兩種睡眠監測儀進行評價和比較. 甘肅科技, 2019, 35(12): 40-42.
29.	余松林. 醫學統計學. 北京: 人民衛生出版社, 2002: 164-178.

1. 孫可欣, 鄭榮壽, 張思維, 等. 2015年中國分地區惡性腫瘤發病和死亡分析. 中國腫瘤, 2019, 28(1): 1-11.
2. 曾煥虹, 傅衛, 孫濤, 等. 腹腔鏡直腸癌根治術后患者的長期生存及其影響因素. 中華普通外科雜志, 2018, 33(1): 25-29.
3. Sch?fer AO. Local imaging of rectal cancer—update 2015: MRI as imaging biomarker. Radiologe, 2015, 55(11): 1015-1026.
4. 錢海峰, 孫勝杰, 吳曉, 等. 動態對比增強磁共振鑒別高級別腦膠質瘤和單發腦轉移瘤的價值. 實用放射學雜志, 2016, 32(1): 5-9.
5. 高永偉, 牛廣明, 韓曉東. 3.0T磁共振擴散加權成像診斷直腸癌最適b值的選取. 臨床軍醫雜志, 2012, 40(6): 1464-1467.
6. 高欣, 周麗娟, 徐孝秋, 等. 動態增強磁共振成像定量參數直方圖分析與鼻咽癌臨床分期的相關性初步研究. 實用放射學雜志, 2019, 35(10): 1590-1594.
7. Kim YE, Lim JS, Choi J, et al. Perfusion parameters of dynamic contrast-enhanced magnetic resonance imaging in patients with rectal cancer: correlation with microvascular density and vascular endothelial growth factor expression. Korean J Radiol, 2013, 14(6): 878-885.
8. 沈浮, 陸建平, 陳錄廣, 等. 動態增強磁共振成像與直腸癌分化程度的相關性研究. 放射學實踐, 2015, 30(10): 1031-1035.
9. 唐翠, 續晉銘, 盧曉玲, 等. 不同病理特征直腸癌的MR灌注成像參數分析. 中國醫學影像技術, 2016, 32(10): 1540-1544.
10. 張文文, 黃剛, 周星, 等. DCE-MRI定量參數與直腸癌病理分期及分級的相關性研究. 臨床放射學雜志, 2016, 35(7): 1058-1061.
11. 肖曉娟, 盧寶蘭, 楊心悅, 等. 定量磁共振灌注成像用于評價直腸癌的微血管灌注及滲透性. 中國病理生理雜志, 2015, 31(12): 2164-2168.
12. 宋媛, 丁爽, 賈文霄. DCE-MRI評價腫瘤血管生成的實驗研究. 放射學實踐, 2014, 29(6): 640-643.
13. 聶丹, 黃瑾瑜, 郭亮, 等. 動態增強磁共振定量分析在直腸癌術前診斷中的應用價值. 臨床放射學雜志, 2018, 37(5): 807-811.
14. 謝宗源, 徐香玖, 黃剛, 等. 直腸癌DCE-MRI參數與病理特征的相關性研究. 磁共振成像, 2015, 6(4): 289-293.
15. Yeo DM, Oh SN, Jung CK, et al. Correlation of dynamic contrast-enhanced MRI perfusion parameters with angiogenesis and biologic aggressiveness of rectal cancer: Preliminary results. J Magn Reson Imaging, 2015, 41(2): 474-480.
16. Yao WW, Zhang H, Ding B, et al. Rectal cancer: 3D dynamic contrast-enhanced MRI; correlation with microvascular density and clinicopathological features. Radiol Med, 2011, 116(3): 366-374.
17. Morvan D. In vivo measurement of diffusion and pseudo-diffusion in skeletal muscle at rest and after exercise. Magn Reson Imaging, 1995, 13(2): 193-199.
18. 蔣杰, 曲源, 夏迎洪, 等. 磁共振擴散成像的原理及應用. 新疆醫學, 2011, 41(11): 69-72.
19. 高永偉, 牛廣明, 韓曉東. 3.0T磁共振診斷直腸癌ADC值與腫瘤分化程度的相關性分析. 中國醫療前沿, 2012, 07(6): 7-8.
20. 齊英杰, 張景忠, 楊明俐, 等. MRI擴散加權成像在直腸癌術前診斷中的應用優勢. 臨床放射學雜志, 2019, 38(3): 475-478.
21. Akashi M, Nakahusa Y, Yakabe T, et al. Assessment of aggressiveness of rectal cancer using 3-T MRI: correlation between the apparent diffusion coefficient as a potential imaging biomarker and histologic prognostic factors. Acta Radiol, 2014, 55(5): 524-531.
22. Curvo-Semedo L, Lambregts DM, Maas M, et al. Diffusion-weighted MRI in rectal cancer: apparent diffusion coefficient as a potential noninvasive marker of tumor aggressiveness. J Magn Reson Imaging, 2012, 35(6): 1365-1371.
23. 朱麗娜, 顏社平, 盧喜, 等. 不同組織分化類型與臨床分期直腸癌的ADC值研究. 臨床放射學雜志, 2016, 35(5): 746-749.
24. 陸志華, 錢偉新, 曹文洪, 等. 磁共振擴散加權成像對直腸癌T分期的診斷價值. 中華胃腸外科雜志, 2015, 17(3): 257-261.
25. 羅偉, 張亞林, 周理超. 不同b值擴散加權成像對前列腺中央腺體局限性病變良惡性的診斷價值. 實用放射學雜志, 2019, 35(9): 1460-1463, 1475.
26. 陳衛中, 倪宗瓚, 潘曉平, 等. 用ROC曲線確定最佳臨界點和可疑值范圍. 現代預防醫學, 2005, 32(7): 729-731.
27. 杜麗新, 李書清, 李鳳蓮, 等. ROC曲線確定最佳臨界點的方法探討. 標記免疫分析與臨床, 2015, 22(8): 823-824.
28. 王旭斌, 趙媛, 范杰, 等. 應用ROC曲線對兩種睡眠監測儀進行評價和比較. 甘肅科技, 2019, 35(12): 40-42.
29. 余松林. 醫學統計學. 北京: 人民衛生出版社, 2002: 164-178.

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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Application value of dynamic contrast-enhanced magnetic resonance imaging quantitative parameters and apparent diffusion coefficient value in evaluating differentiation degrees and T stages of rectal cancer

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