Title:T1 Mapping and Amide Proton Transfer Weighted Imaging for Predicting
Lymph Node Metastasis in Patients with Rectal Cancer
Volume: 20
Author(s): Yue Wang, Anliang Chen, Wenjun Hu, Yuhui Liu, Jiazheng Wang, Liangjie Lin, Qingwei Song and Ailian Liu*
Affiliation:
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, 116011, P.R. China
- Dalian Engineering Research Center for Artificial Intelligence in Medical Imaging, Dalian, Liaoning, 116011, P.R. China
Keywords:
Amide proton transfer weighted (APTw), T1-mapping, Rectal cancer, LN metastasis, Adenocarcinoma, ICC.
Abstract:
Background:
Accurate preoperative judgment of lymph node (LN) metastasis is a critical step in creating a treatment strategy and evaluating prognosis in rectal
cancer (RC) patients.
Objective:
This study aimed to explore the value of T1 mapping and amide proton transfer weighted (APTw) imaging in predicting LN metastasis in patients
with rectal cancer.
Methods:
In a retrospective study, twenty-three patients with pathologically confirmed rectal adenocarcinoma who underwent MRI and surgery from August
2019 to August 2021 were selected. Then, 3.0T/MR sequences included conventional sequences (T1WI, T2WI, and DWI), APTw imaging, and T1
mapping. Patients were divided into LN metastasis (group A) and non-LN metastasis groups (group B). The intra-group correlation coefficient
(ICC) was used to test the inter-observer consistency. Mann-Whitney U test was used to compare the differences between the two groups.
Spearman correlation analysis was performed to evaluate the correlation between T1 and APT values. Logistic regression and receiver operating
characteristic (ROC) curve analyses were performed to assess the differential performance of each parameter and their combination. The difference
between AUCs was compared using the DeLong test.
Results:
The APT value in patients with LN metastasis was significantly higher than in those without LN metastasis group (P=0.020). Also, similar results
were observed for the T1 values (P=0.001). The area under the ROC curve of the APT value in the prediction of LN metastasis was 0.794; when
the cutoff value was 1.73%, the sensitivity and specificity were 71.4% and 88.9%, respectively. The area under the ROC curve of the T1 value was
0.913; when the cutoff value was 1367.36 ms, the sensitivity and specificity were 78.6% and 100.0%, respectively. The area under the ROC curve
of T1+APT was 0.929, with a sensitivity of 78.6% and specificity of 100.0%.
Conclusion:
APT and T1 values show great diagnostic efficiency in predicting LN metastasis in rectal cancer.
