Diffusion-weighted imaging in rectal cancer: current applications and future perspectives.

Area of Science:

• Radiology
• Oncology
• Medical Imaging

Background:

• Diffusion-weighted imaging (DWI) has evolved from qualitative to quantitative analysis for rectal cancer.
• Over 140 papers highlight its growing importance in the last decade.

Purpose of the Study:

• To review current applications and clinical utility of DWI in rectal cancer.
• To provide an overview of emerging DWI techniques and their research status.

Main Methods:

• Literature review of over 140 papers published in the last decade.
• Analysis of qualitative and quantitative DWI applications.
• Evaluation of novel DWI techniques like IVIM, DKI, and postprocessing tools.

Main Results:

• Established benefit of DWI for assessing residual rectal tumor after neoadjuvant treatment, aiding in post-radiation fibrosis differentiation.
• Quantitative DWI (ADC) shows potential for response prediction and prognostication, pending standardization and validation.
• DWI's role in tumor and nodal staging is less defined, but may assist in lymph node detection.

Conclusions:

• DWI is clinically valuable for assessing rectal cancer treatment response, particularly visually.
• Quantitative DWI requires standardization and prospective validation for broader clinical adoption.
• Emerging DWI methods show promise but need further research to establish clinical utility.