Intravoxel incoherent motion diffusion-weighted imaginin the staging of rectal non-mucinous adenocarcinoma
Polish Journal of Radiology, cilt.91, 2026 (ESCI, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 91
- Basım Tarihi: 2026
- Doi Numarası: 10.5114/pjr/215289
- Dergi Adı: Polish Journal of Radiology
- Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, EMBASE, Academic Search Ultimate (EBSCO)
- Anahtar Kelimeler: rectal cancer, staging, magnetic resonance imaging, lymph node, diffusion-weighted imaging, intravoxel incoherent motion
- Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Purpose: To investigate the role of intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) in thprediction of histological differentiation and local invasion (T stage) of rectal non-mucinous adenocarcinoma foappropriate treatment planning. Material and methods: Pre-operative magnetic resonance imaging (MRI) and IVIM-DWI examinations were pro-spectively performed in patients with rectal non-mucinous adenocarcinoma. A total of 36 patients with a mean age of 61 ± 8 years (range: 26-85 years) were included. Size, signal intensities and enhancement pattern of tumors, lymphadenopathy, serosal involvement, adjacent organ invasion, and metastasis were noted. IVIM-DWI parameters were estimated. Relationships between IVIM-DWI parameters and histopathological results were analyzed using Mann-Whitney U and Kruskal-Wallis tests. Receiver operating characteristic analysis was performed for optimal cut-off values. Results: In our study, a total of 36 patients were enrolled. There was a negative relationship between tumor differentiation and perfusion (f) (p < 0.05). A negative relationship was detected between T staging and true diffusion (D), pseudo-diffusion coefficient (D*) and apparent diffusion coefficient (ADC) values (p < 0.05). Lower D, D*, and ADC values were detected in late stage (T3-T4) rectal tumors and nodal metastasis (p < 0.05). Lower f values were achieved in higher histological grades (p < 0.05). In differentiation of poorly from well-and moderately differentiated tumors, cut-off value of < 20.89 showed 88.5% sensitivity and 85.7% specificity (area under the curve: 0.771, p < 0.05). Conclusions: Aggressive tumors with low histological differentiation and metastatic lymphadenopathy exhibit lower diffusion and perfusion values. As a perfusion indicator, f provides valuable information regarding tumor differen-tiation. IVIM-DWI can be used as an adjunctive modality to routine abdominal MRI in the local staging of rectal carcinoma.