Non-invasive MR assessment of the microstructure and microcirculation in regional lymph nodes for rectal cancer: a study of intravoxel incoherent motion imaging

Abstract Background The aim of this study is to evaluate the microstructure and microcirculation of regional lymph nodes (LNs) in rectal cancer by using non-invasive intravoxel incoherent motion MRI (IVIM-MRI), and to distinguish metastatic from non-metastatic LNs by quantitative parameters. Methods All recruited patients underwent IVIM-MRI (b = 0, 5, 10, 20, 30, 40, 60, 80, 100, 150, 200, 400, 600, 1000, 1500 and 2000 s/mm2) on a 3.0 T MRI system. One hundred sixty-eight regional LNs with a short-axis diameter equal to or greater than 5 mm from 116 patients were evaluated by two radiologists independently, including 78 malignant LNs and 90 benign LNs. The following parameters were assessed: the short-axis diameter (S), long-axis diameter (L), short- to long-axis diameter ratio (S/L), pure diffusion coefficient (D), pseudo-diffusion coefficient (D*), and perfusion factor (f). Intraclass correlation coefficients (ICCs) were calculated to assess the interobserver agreement between two readers. Receiver operating characteristic curves were applied for analyzing statistically significant parameters. Results Interobserver agreement of IVIM-MRI parameters between two readers was excellent (ICCs> 0.75). The metastatic group exhibited higher S, L and D (P < 0.001), but lower f (P < 0.001) than the non-metastatic group. The area under the curve (95% CI, sensitivity, specificity) of the multi-parameter combined equation for D, f and S was 0.811 (0.744~0.868, 62.82%, 87.78%). The diagnostic performance of the multi-parameter model was better than that of an individual parameter (P < 0.05). Conclusion IVIM-MRI parameters provided information about the microstructure and microcirculation of regional LNs in rectal cancer, also improved diagnostic performance in identifying metastatic LNs.

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Value of intravoxel incoherent motion magnetic resonance imaging for differentiating metastatic from nonmetastatic mesorectal lymph nodes with different short-axis diameters in rectal cancer

Journal of Cancer Research and Therapeutics ◽

10.4103/jcrt.jcrt_76_19 ◽

2019 ◽

Vol 15 (7) ◽

pp. 1508

Author(s):

Xinjie Liu ◽

Ling Long ◽

Haiping Zhang ◽

Xiaojing He ◽

Jun Zhou ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Rectal Cancer ◽

Magnetic Resonance ◽

Lymph Nodes ◽

Intravoxel Incoherent Motion ◽

Short Axis ◽

Resonance Imaging

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Role of Quantitative Dynamic Contrast-Enhanced MRI in Evaluating Regional Lymph Nodes With a Short-Axis Diameter of Less Than 5 mm in Rectal Cancer

American Journal of Roentgenology ◽

10.2214/ajr.18.19866 ◽

2019 ◽

Vol 212 (1) ◽

pp. 77-83 ◽

Cited By ~ 4

Author(s):

Xinyue Yang ◽

Yan Chen ◽

Ziqiang Wen ◽

Baolan Lu ◽

Bingqi Shen ◽

...

Keyword(s):

Rectal Cancer ◽

Lymph Nodes ◽

Short Axis ◽

Regional Lymph Nodes ◽

Dynamic Contrast Enhanced Mri ◽

Dynamic Contrast Enhanced ◽

Enhanced Mri ◽

Contrast Enhanced ◽

Contrast Enhanced Mri

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Apparent diffusion coefficient cannot discriminate metastatic and non-metastatic lymph nodes in rectal cancer: a meta-analysis

International Journal of Colorectal Disease ◽

10.1007/s00384-021-03986-8 ◽

2021 ◽

Author(s):

Alexey Surov ◽

Hans-Jonas Meyer ◽

Maciej Pech ◽

Maciej Powerski ◽

Jasan Omari ◽

...

Keyword(s):

Rectal Cancer ◽

Diffusion Coefficient ◽

Apparent Diffusion Coefficient ◽

Lymph Nodes ◽

Meta Analysis ◽

Adc Value ◽

Metastatic Lymph Nodes ◽

Metastatic Lymph ◽

Apparent Diffusion ◽

Adc Values

Abstract Background Our aim was to provide data regarding use of diffusion-weighted imaging (DWI) for distinguishing metastatic and non-metastatic lymph nodes (LN) in rectal cancer. Methods MEDLINE library, EMBASE, and SCOPUS database were screened for associations between DWI and metastatic and non-metastatic LN in rectal cancer up to February 2021. Overall, 9 studies were included into the analysis. Number, mean value, and standard deviation of DWI parameters including apparent diffusion coefficient (ADC) values of metastatic and non-metastatic LN were extracted from the literature. The methodological quality of the studies was investigated according to the QUADAS-2 assessment. The meta-analysis was undertaken by using RevMan 5.3 software. DerSimonian, and Laird random-effects models with inverse-variance weights were used to account the heterogeneity between the studies. Mean DWI values including 95% confidence intervals were calculated for metastatic and non-metastatic LN. Results ADC values were reported for 1376 LN, 623 (45.3%) metastatic LN, and 754 (54.7%) non-metastatic LN. The calculated mean ADC value (× 10−3 mm2/s) of metastatic LN was 1.05, 95%CI (0.94, 1.15). The calculated mean ADC value of the non-metastatic LN was 1.17, 95%CI (1.01, 1.33). The calculated sensitivity and specificity were 0.81, 95%CI (0.74, 0.89) and 0.67, 95%CI (0.54, 0.79). Conclusion No reliable ADC threshold can be recommended for distinguishing of metastatic and non-metastatic LN in rectal cancer.

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A predictive nomogram improved diagnostic accuracy and interobserver agreement of perirectal lymph nodes metastases in rectal cancer

Oncotarget ◽

10.18632/oncotarget.7548 ◽

2016 ◽

Vol 7 (12) ◽

pp. 14755-14764 ◽

Cited By ~ 5

Author(s):

Yongfeng Liu ◽

Renjie Wang ◽

Ying Ding ◽

Shanshan Tu ◽

Yi Liu ◽

...

Keyword(s):

Rectal Cancer ◽

Lymph Nodes ◽

Diagnostic Accuracy ◽

Interobserver Agreement ◽

Lymph Nodes Metastases

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Reproducibility of measurements with a semi-automatic software package for the evaluation of rectal cancer

Acta Radiologica ◽

10.1177/0284185119873118 ◽

2019 ◽

Vol 61 (5) ◽

pp. 586-594

Author(s):

Lisa Hörberg ◽

Daniel Roth ◽

Peter Leander ◽

Sven Månsson ◽

Tobias Fält ◽

...

Keyword(s):

Rectal Cancer ◽

Diffusion Coefficient ◽

Apparent Diffusion Coefficient ◽

Lymph Nodes ◽

Software Package ◽

Cancer Management ◽

Mri Staging ◽

Before And After ◽

Apparent Diffusion ◽

Chemoradiation Treatment

Background Staging of rectal cancer with MRI has major impact on treatment choice and may be of importance in new cancer management strategies such as “wait-and-see” policy. Purpose To assess the reproducibility of a software package recently developed at our department to measure volumes, apparent diffusion coefficient, and the skewness of apparent diffusion coefficient in lymph nodes and tumors in rectal cancer patients before and after chemoradiation treatment. Material and Methods This study included 20 consecutive patients with biopsy-verified rectal cancer, in whom MRI staging had been performed both before and after chemoradiation treatment. The diffusion-weighted images were transferred to the software. The volume, apparent diffusion coefficient, and skewness were determined for 93 lymph nodes and 40 tumors. The volumes were compared with manual measurements of the volume of the same lymph nodes and tumors. Results The agreement in semi-automatic measurements of lymph nodes was very good (ICC = 0.99), and in tumors good (ICC = 0.88). The agreement in manual measurements of lymph nodes was very good (ICC = 0.95) when all lymph nodes were included, but low (ICC = 0.52) if three outliers were excluded. Bland–Altman plots showed clear agreement between manual and semi-automatic measurements in the lymph nodes, but not in measurements of tumors. The values of apparent diffusion coefficient and skewness in tumors differed before and after treatment but did not differ in lymph nodes as a group. Conclusion The software package showed a high degree of reproducibility in measurements on lymph nodes but requires further development to improve the reproducibility of tumor measurements.

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