Correlation between diffusion kurtosis and intravoxel incoherent motion derived (IVIM) parameters and tumor tissue...

To correlate non-invasive quantitative diffusion kurtosis imaging (DKI) and intravoxel incoherent motion-derived (IVIM) parameters with rectal cancer composition assessed by the expression of caudal-type homeobox 2 (CDX-2), Vimentin (VIM), CD34 and Ki-67 on resected tissues, as well as the tumor stroma ratio (TSR) and the results of H&E and Masson staining.

A prospective study of 26 patients with rectal cancer who underwent magnetic resonance (MR) imaging, including DKI with 4 b values and IVIM at 3.0 T prior to surgery. Primary tumor was harvested and fixed for H&E, immunohistochemistry and Masson staining. One-way ANOVA was used to test the differences. Pearson correlation coefficients and multiple linear regression analyses were applied to evaluation the correlations.

The apparent diffusion coefficient (ADC_DKI) and MK_DKI all exhibited significant differences in subgroups with different T stages (P < 0.05) and among high- and low- grade rectal cancer (P < 0.05). MD_DKI showed a moderate negative correlation with CDX-2 (r = - 0.42, P = 0.040) and a moderate positive correlation with CD34 (r = 0.42, P = 0.041). ADC_IVIM exhibited a moderate positive correlation with Masson staining (r = 0.426, P = 0.048) D_IVIM showed a moderate negative correlation with CDX-2 (r = - 0.58, P = 0.005). [Formula: see text] showed a moderate positive correlation with VIM (r = 0.445, P = 0.033).

ADC_DKI and MK_DKI demonstrated a higher correlation with T stages and histologic grades. MD_DKI showed significant correlations with CDX-2 and CD34. ADC_IVIM showed significant correlation with Masson. D_IVIM showed significant correlations with CDX-2 and [Formula: see text] showed significant correlation with VIM. These findings should be validated in a larger study.