Discriminating Tumor Deposits From Metastatic Lymph Nodes in Rectal Cancer: A Pilot Study Utilizing Dynamic...

Area of Science:

• Radiology
• Oncology
• Medical Imaging

Background:

• Distinguishing tumor deposits (TDs) from metastatic lymph nodes (MLNs) is crucial for rectal cancer staging and treatment.
• Accurate preoperative differentiation impacts surgical planning and patient outcomes.

Purpose of the Study:

• To assess the feasibility of dynamic contrast-enhanced MRI (DCE-MRI) in differentiating TDs from MLNs in rectal cancer.
• To evaluate the diagnostic performance of quantitative MRI parameters in this differentiation.

Main Methods:

• Retrospective analysis of 70 rectal cancer patients with 168 histopathologically confirmed lesions (70 TDs, 98 MLNs).
• Analysis of morphological features and quantitative parameters from DCE-MRI (Ktrans, kep, ve) and DWI (ADC values).
• Utilized multivariable logistic regression and ROC curve analysis to determine diagnostic accuracy.

Main Results:

• Significant differences were observed in morphological features and DCE-MRI parameters (P < 0.05) between TDs and MLNs.
• ADC values did not show significant differences (P > 0.05).
• The parameter 've' demonstrated the highest AUC (0.772) for single-parameter differentiation. A combined model achieved an AUC of 0.833.

Conclusions:

• DCE-MRI parameters and morphological features are valuable for differentiating TDs from MLNs in rectal cancer.
• Combining imaging features and quantitative parameters enhances preoperative diagnostic accuracy.
• This approach aids in improved surgical and treatment planning for rectal cancer.