Amide proton transfer-weighted MRI for assessing rectal adenocarcinoma T-staging and perineural invasion: a prospective study.

IF 4.7 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING European Radiology Pub Date : 2025-02-01 Epub Date: 2024-08-09 DOI:10.1007/s00330-024-11000-2

Caixia Zhang, Jianyou Chen, Yifan Liu, Yinrui Yang, Yongzhou Xu, Ruimin You, Yanli Li, Lizhu Liu, Ling Yang, Huaxiu Li, Guanshun Wang, Wenliang Li, Zhenhui Li

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Abstract

Objective: To investigate the value of the pre-operative amide proton transfer-weighted (APTw) MRI to assess the prognostic factors in rectal adenocarcinoma (RA).

Methods: This prospective study ran from January 2022 to September 2023 and consecutively enrolled participants with RA who underwent pre-operative MRI and radical surgery. The APTw signal intensity (SI) values of RA with various tumor (T), node (N) stages, perineural invasion (PNI), and tumor grade were compared by Mann-Whitney U-test or t-test. The receiver operating characteristic curve was used to evaluate the diagnostic performance of the APTw SI values.

Results: A total of 51 participants were enrolled (mean age, 58 years ± 10 [standard deviation], 26 men). There were 24 in the T1-T2 stage and 9 with positive PNI. The APTw SI max, 99th, and 95th values were significantly higher in T3-T4 stage tumor than in T1-T2; the median (interquartile range) (M (IQR)) was (4.0% (3.6-4.9%) vs 3.4% (2.9- 4.3%), p = 0.017), (3.7% (3.2-4.1%) vs 3.2% (2.8-3.8%), p = 0.013), and (3.3% (2.8-3.8%) vs 2.9% (2.3-3.5%), p = 0.033), respectively. These indicators also differed significantly between the PNI groups, with the M (IQR) (4.5% (3.6-5.7%) vs 3.7% (3.2-4.2%), p = 0.017), (4.1% (3.4-4.8%) vs 3.3% (3.0-3.9%), p = 0.022), and (3.7% (2.7-4.2%) vs 2.9% (2.6-3.5%), p = 0.045), respectively.

Conclusion: Pre-operative APTw MRI has potential value in the assessment of T-staging and PNI determination in RA.

Clinical relevance statement: Pre-operative amide proton transfer-weighted MRI provides a quantitative method for noninvasive assessment of T-staging and PNI in RA aiding in precision treatment planning.

Key points: The efficacy of APTw MRI in RA needs further investigation. T3-T4 stage and PNI positive APTw signal intensities were higher than T1-T2 and non-PNI, respectively. APTw MRI provides a quantitative method for assessment of T staging and PNI in RA.

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酰胺质子转移加权磁共振成像用于评估直肠腺癌的 T 型分期和神经周围侵犯：一项前瞻性研究。

目的研究术前酰胺质子转移加权（APTw）磁共振成像对评估直肠腺癌（RA）预后因素的价值：这项前瞻性研究从2022年1月持续到2023年9月，连续纳入了接受术前磁共振成像和根治手术的RA患者。采用 Mann-Whitney U 检验或 t 检验比较不同肿瘤（T）、结节（N）分期、神经周围浸润（PNI）和肿瘤分级的 RA 的 APTw 信号强度（SI）值。采用接收者操作特征曲线评估 APTw SI 值的诊断性能：共有 51 名参与者（平均年龄为 58 岁 ± 10 [标准差]，26 名男性）。其中 24 人处于 T1-T2 阶段，9 人 PNI 阳性。T3-T4 期肿瘤的 APTw SI 最大值、第 99 位值和第 95 位值明显高于 T1-T2 期；中位数（四分位间距）（M（IQR））为 4.0% (3.6-4.9%) vs 3.4% (2.9- 4.3%), p = 0.017）、（3.7% (3.2-4.1%) vs 3.2% (2.8-3.8%), p = 0.013）和（3.3% (2.8-3.8%) vs 2.9% (2.3-3.5%), p = 0.033）。这些指标在 PNI 组之间也有明显差异，M（IQR）分别为（4.5% (3.6-5.7%) vs 3.7% (3.2-4.2%)，p = 0.017）、（4.1% (3.4-4.8%) vs 3.3% (3.0-3.9%)，p = 0.022）和（3.7% (2.7-4.2%) vs 2.9% (2.6-3.5%)，p = 0.045）：结论：术前酰胺质子核磁共振成像在评估RA的T分期和确定PNI方面具有潜在价值：术前酰胺质子转移加权磁共振成像为无创评估RA的T分期和PNI提供了一种定量方法，有助于制定精确的治疗计划：要点：APTw MRI在RA中的疗效有待进一步研究。T3-T4分期和PNI阳性APTw信号强度分别高于T1-T2和非PNI。APTw MRI为评估RA的T分期和PNI提供了一种定量方法。

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来源期刊

European Radiology 医学-核医学

CiteScore

11.60

自引率

8.50%

发文量

874

审稿时长

2-4 weeks

期刊介绍： European Radiology (ER) continuously updates scientific knowledge in radiology by publication of strong original articles and state-of-the-art reviews written by leading radiologists. A well balanced combination of review articles, original papers, short communications from European radiological congresses and information on society matters makes ER an indispensable source for current information in this field. This is the Journal of the European Society of Radiology, and the official journal of a number of societies. From 2004-2008 supplements to European Radiology were published under its companion, European Radiology Supplements, ISSN 1613-3749.