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Clinical Article
Clinical application of whole-volume apparent diffusion coefficient histogram parameters of histological grading rectal adenocarcinoma
DONG Lijie  ZHANG Lin  GAO Xiaoyuan  JIANG Xingyue  MENG Hongxiu  TIAN Chunmei  CHEN Liang 

Cite this article as: Dong LJ, Zhang L, Gao XY, et al. Clinical application of whole-volume apparent diffusion coefficient histogram parameters of histological grading rectal adenocarcinoma[J]. Chin J Magn Reson Imaging, 2022, 13(7): 48-54. DOI:10.12015/issn.1674-8034.2022.07.009.


[Abstract] Objective To explore the role of whole-lesion histogram analysis of apparent diffusion coefficient (ADC) in discriminating histological grades of rectal carcinoma.Materials and Methods Altogether, 121 patients with rectal cancer were enrolled in this retrospective study. All patients received preoperative 3.0 T MRI scan. The regions of interest (ROIs) were drawn by FireVoxel software and histogram analysis was carried out. The parameters, which include ADCmin, ADCmax, ADCmean, 5th, 10th, 25th, 50th, 75th, 90th, 95th percentiles, skewness, and kurtosis, and were compared between different histological grades of rectal cancer by variance analysis. The Spearman correlation test was used to analyze correlations between histological grade and histogram parameters. Logistic regression was used to find out the optimal combination model. The diagnostic performance of individual parameters for distinguishing different differentiated tumors was assessed by receiver operating characteristic (ROC) curve analysis.Results There were significant differences for ADCmean, 75th, 90th percentiles, skewness, and kurtosis of diffusion weighted imaging sequence between well, moderately, and poorly differentiated rectal cancers (P<0.05). Significant correlations were noted between histological grades and the above histogram parameters (r=0.548, 0.568, 0.563, -0.555, -0.760, respectively, P<0.05). Among the histogram parameter, kurtosis achieved the highest area under the curve (AUC) of 0.918 with an optimal cutoff value of 2.045 in distinguishing poorly from well/moderately differentiated rectal cancers. The combination of ADCmean, 75th percentile, 90th percentile, skewness and kurtosis yielded the highest AUC of 0.928.Conclusions Quantitative whole-lesion ADC histogram analysis parameters, which include ADCmean, 75th, 90th percentiles, skewness, and kurtosis, could help differentiate histological grades of rectal cancer. The combination of ADCmean, 75th percentile, 90th percentile, skewness and kurtosis may be the best choice.
[Keywords] rectal cancer;magnetic resonance imaging;apparent diffusion coefficient;histogram analysis;histological grade

DONG Lijie1   ZHANG Lin1   GAO Xiaoyuan1   JIANG Xingyue1   MENG Hongxiu2   TIAN Chunmei3   CHEN Liang1*  

1 Department of Radiology, Binzhou Medical University Hospital, Binzhou 256603, China

2 Department of Internal Medicine, Wudi County People's Hospital, Binzhou 251900, China

3 Department of Pediatrics, Binzhou Medical University Hospital, Binzhou 256603, China

Chen L, E-mail: byfychl@163.com

Conflicts of interest   None.

Received  2022-03-22
Accepted  2022-07-04
DOI: 10.12015/issn.1674-8034.2022.07.009
Cite this article as: Dong LJ, Zhang L, Gao XY, et al. Clinical application of whole-volume apparent diffusion coefficient histogram parameters of histological grading rectal adenocarcinoma[J]. Chin J Magn Reson Imaging, 2022, 13(7): 48-54.DOI:10.12015/issn.1674-8034.2022.07.009

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