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Optimal b-value selection for apparent diffusion coefficient (ADC) in rectal cancer is crucial. Using higher b-values (≥ 100 s/mm²) and excluding low b-values (≤ 100 s/mm²) reduces uncertainty in ADC quantification.

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Area of Science:

  • Radiology
  • Oncology
  • Medical Imaging

Background:

  • Apparent diffusion coefficient (ADC) quantification in rectal cancer typically uses a monoexponential model.
  • Optimal b-value selection for ADC in rectal cancer remains undefined.
  • Diffusion-weighted MRI (DWI) is essential for assessing rectal cancer characteristics.

Purpose of the Study:

  • To evaluate the influence of various b-value combinations on ADC values in rectal cancer.
  • To determine optimal b-value selection for accurate ADC quantification in rectal cancer using a monoexponential model.
  • To compare ADC values derived from different b-value combinations against a biexponential reference.

Main Methods:

  • Prospective observational study of 23 rectal cancer patients (OxyTarget study, NCT01816607).
  • Diffusion-weighted MRI (DWI) acquired with seven b-values (0-1300 s/mm²) on a 1.5T scanner.
  • Whole-tumour volumes of interest delineated by two radiologists; ADC calculated using 18 b-value combinations.

Main Results:

  • Tumour ADC values varied significantly based on b-value combinations.
  • Excluding low b-values (≤ 100 s/mm²) resulted in reduced ADC values.
  • Using b-values ≥ 500 s/mm² (two or three values, including 1000 s/mm²) showed the smallest deviation from the biexponential reference, while including b=0 s/mm² caused overestimation.

Conclusions:

  • Rectal cancer ADC quantification using the monoexponential model is highly sensitive to b-value selection.
  • Eliminating low b-values (≤ 100 s/mm²) reduces calculation uncertainty by minimizing perfusion effects.
  • Recommended use of b-values > 100 s/mm², including a high b-value (≥ 1000 s/mm²), for reliable ADC assessment in rectal cancer.