Discrimination Between Metastatic and Non-metastatic Regional Lymph Nodes in Rectal Cancer Via Diffusional Kurtosis Imaging
10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2025.0414
- VernacularTitle:扩散峰度成像鉴别直肠癌区域淋巴结良恶性的初步探讨
- Author:
Xinni CAI
1
;
Shenping YU
;
Xinyue YANG
Author Information
1. 中山大学附属第一医院放射科,广东 广州 510080
- Publication Type:Journal Article
- Keywords:
rectal cancer;
lymph nodes;
diffusional kurtosis imaging;
magnetic resonance imaging;
diffusion weighted imaging
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2025;46(4):676-685
- CountryChina
- Language:Chinese
-
Abstract:
[Objective]To evaluate the diagnostic value of quantitative diffusion kurtosis imaging(DKI)parameters in discriminating metastatic from non-metastatic regional lymph nodes in rectal cancer.[Methods]Totally 116 patients who underwent preoperative DKI scanning and radical rectal cancer surgery without neoadjuvant therapy between January 2015 and August 2016,and 285 lymph nodes,including metastatic lymph nodes(MLNs,n=104)and non-metastatic lymph nodes(NMLNs,n=181),were analyzed.The short-axis diameter(S),apparent diffusion coefficient(ADC),mean kurtosis coefficient(MK),and mean diffusion coefficient(MD)were compared between the two groups,with S=5.5 mm as a cutoff value.Receiver operating characteristic(ROC)curves were utilized to assess diagnostic efficiency and determine optimal cutoff values.[Results]Metastatic lymph nodes exhibited significantly higher S,ADC,and MD values(P＜0.05),but markedly lower MK values(P＜0.01)compared with non-metastatic lymph nodes.The optimal cutoff values for MK[area under the curve(AUC),sensitivity,specificity]in discriminating metastatic from non-metastatic lymph nodes were 1.150(0.634,80.77%,45.86%).Subgroup analysis revealed that when S≥5.5 mm,MK was lower in metastatic lymph nodes than in non-metastatic nodes(P=0.037),with optimal cutoff values(AUC,sensitivity,specificity)of 1.213(0.604,87.50%,36.51%).No significant differences were observed in S,ADC,or MD between the groups(P＞0.05).When S＜5.5 mm,metastatic lymph nodes showed higher ADC and MD but lower MK than non-metastatic nodes(P＜0.05).The optimal cutoff values(AUC,sensitivity,specificity)for MK in this subgroup were 1.108(0.655,81.25%,55.93%).No significant difference in S was observed(P=0.097).[Conclusion]The DKI quantitative parameter MK can effectively discriminate regional MLNs from NMLNs in rectal cancer.Combining S with MK may further enhance diagnostic accuracy.
