The Multipurpose Usage of Diffusion-Weighted MRI in Rectal Cancer

Area of Science:

• Oncology
• Radiology
• Medical Imaging

Background:

• Colorectal cancer is a leading global oncological disease.
• Standard treatment for locally advanced rectal tumors involves neoadjuvant radiochemotherapy and surgery.
• MRI findings are crucial for treatment planning.

Purpose of the Study:

• To evaluate the role of apparent diffusion coefficient (ADC) measurements in rectal cancer.
• To explore ADC's utility in various clinical scenarios.
• To assess ADC changes after neoadjuvant chemoradiotherapy.

Main Methods:

• Rectal MRI was performed on 135 patients (75 with rectal adenocarcinoma, 60 disease-free).
• Apparent diffusion coefficient (ADC) measurements were obtained from the region of interest.
• Eighteen rectal cancer patients underwent a second MRI post-neoadjuvant chemoradiotherapy for ADC comparison.

Main Results:

• Rectal cancer ADC values were significantly lower than controls (p < 0.001).
• Lower ADC values correlated with higher T stages (p = 0.039) and extramural vascular invasion (p = 0.01).
• ADC values significantly increased post-treatment (p < 0.001), with low initial ADC predicting a greater increase (r = -0.6572, p = 0.004).

Conclusions:

• ADC measurements offer a complementary role in assessing rectal cancer.
• ADC has potential in predicting chemoradiotherapy response.
• ADC can improve the planning of rectal cancer treatment strategies.