Value of IVIM-DWI combined with texture analysis based on T2WI to differentiate T2 from T3 stage in rectal cancer preopera-tively
Objective To investigate the value of IVIM-DWI combined with texture analysis based on T2WI in differentiating T2 from T3 stage of rectal cancer preoperatively.Methods Retrospective analysis was performed on the clinical data of 105 cases of rectal cancer con-firmed by surgical pathology in West Branch of the First Affiliated Hospital of University of Science and Technology of China(Anhui Provincial Cancer Hospital)from June 2016 to May 2023.The enrolled patients were divided into the T2 stage group(n=57)and the T3 stage group(n=48)according to T stage.All patients underwent conventional rectal MRI and IVIM-DWI scan before surgery.IVIM-DWI parameters of primary rectal cancer were measured,including ADC,D,D*and f,and the three-dimensional texture features based on T2WI were extracted.The differ-ences in IVIM-DWI parameters and texture feature parameters were compared between the two groups,then the texture feature model and com-bined model based on IVIM-DWI and texture feature parameters were established.The receiver operating characteristic(ROC)curves were used to evaluate the performance of each parameter and model in the preoperative prediction about T2 and T3 stage in rectal cancer.Results Among all the IVIM-DWI parameters,the D value of T2 stage group was bigger than T3 stage group,and the f value of T2 stage group was smaller than T3 stage group.Both of them were significantly different(P<0.05),and no statistical significance was found in the ADC and D* val-ues between two groups(both P>0.05).Four texture parameters with statistical significance,including firstorder_90Percentile,glrlm_LRLGLE,glszm_SZN and glszm_SAHGLE,were selected totally from 1874 texture parameters,which extracted from T2WI sequence.The AUC of D,f and four texture feature parameters was 0.705,0.664,0.840,0.740,0.801,0.656 respectively.The AUC of texture feature model and the com-bined model was 0.952 and 0.956,respectively.The AUC of combined model was larger than D,f and the four texture feature parameters(P<0.05),and the sensitivity was 93.9%and the specificity was 87.5%.Conclusion IVIM-DWI parameters combined with texture analysis based on T2WI show better efficacy in differentiating T2 from T3 stage of rectal cancer preoperatively,which may remedy the weakness of conventional MRI to some extent.
Rectal cancerIntrovoxel incohorent movement diffusion weighted imagingTexture analysisT stage
NETL
NSTL
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