Histogram analysis of diffusion-weighted magnetic resonance imaging as a biomarker to predict LNM in T3 stage rectal carcinoma

Abstract Background Preoperative identification of rectal cancer lymph node status is crucial for patient prognosis and treatment decisions. Rectal magnetic resonance imaging (MRI) plays an essential role in the preoperative staging of rectal cancer, but its ability to predict lymph node metastasis...

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Autores principales:	Yang Zhou, Rui Yang, Yuan Wang, Meng Zhou, Xueyan Zhou, JiQing Xing, Xinxin Wang, Chunhui Zhang
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Rectal cancer LNM Multi-parametric magnetic resonance imaging Histogram Nomogram Medical technology R855-855.5
Acceso en línea:	https://doaj.org/article/60415aec794745b3805204f84b4a08a1
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spelling	oai:doaj.org-article:60415aec794745b3805204f84b4a08a12021-11-28T12:30:33ZHistogram analysis of diffusion-weighted magnetic resonance imaging as a biomarker to predict LNM in T3 stage rectal carcinoma10.1186/s12880-021-00706-01471-2342https://doaj.org/article/60415aec794745b3805204f84b4a08a12021-11-01T00:00:00Zhttps://doi.org/10.1186/s12880-021-00706-0https://doaj.org/toc/1471-2342Abstract Background Preoperative identification of rectal cancer lymph node status is crucial for patient prognosis and treatment decisions. Rectal magnetic resonance imaging (MRI) plays an essential role in the preoperative staging of rectal cancer, but its ability to predict lymph node metastasis (LNM) is insufficient. This study explored the value of histogram features of primary lesions on multi-parametric MRI for predicting LNM of stage T3 rectal carcinoma. Methods We retrospectively analyzed 175 patients with stage T3 rectal cancer who underwent preoperative MRI, including diffusion-weighted imaging (DWI) before surgery. 62 patients were included in the LNM group, and 113 patients were included in the non-LNM group. Texture features were calculated from histograms derived from T2 weighted imaging (T2WI), DWI, ADC, and T2 maps. Stepwise logistic regression analysis was used to screen independent predictors of LNM from clinical features, imaging features, and histogram features. Predictive performance was evaluated by receiver operating characteristic (ROC) curve analysis. Finally, a nomogram was established for predicting the risk of LNM. Results The clinical, imaging and histogram features were analyzed by stepwise logistic regression. Preoperative carbohydrate antigen 199 level (p = 0.009), MRN stage (p < 0.001), T2WIKurtosis (p = 0.010), DWIMode (p = 0.038), DWICV (p = 0.038), and T2-mapP5 (p = 0.007) were independent predictors of LNM. These factors were combined to form the best predictive model. The model reached an area under the ROC curve (AUC) of 0.860, with a sensitivity of 72.8% and a specificity of 85.5%. Conclusion The histogram features on multi-parametric MRI of the primary tumor in rectal cancer were related to LN status, which is helpful for improving the ability to predict LNM of stage T3 rectal cancer.Yang ZhouRui YangYuan WangMeng ZhouXueyan ZhouJiQing XingXinxin WangChunhui ZhangBMCarticleRectal cancerLNMMulti-parametric magnetic resonance imagingHistogramNomogramMedical technologyR855-855.5ENBMC Medical Imaging, Vol 21, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Rectal cancer LNM Multi-parametric magnetic resonance imaging Histogram Nomogram Medical technology R855-855.5
spellingShingle	Rectal cancer LNM Multi-parametric magnetic resonance imaging Histogram Nomogram Medical technology R855-855.5 Yang Zhou Rui Yang Yuan Wang Meng Zhou Xueyan Zhou JiQing Xing Xinxin Wang Chunhui Zhang Histogram analysis of diffusion-weighted magnetic resonance imaging as a biomarker to predict LNM in T3 stage rectal carcinoma
description	Abstract Background Preoperative identification of rectal cancer lymph node status is crucial for patient prognosis and treatment decisions. Rectal magnetic resonance imaging (MRI) plays an essential role in the preoperative staging of rectal cancer, but its ability to predict lymph node metastasis (LNM) is insufficient. This study explored the value of histogram features of primary lesions on multi-parametric MRI for predicting LNM of stage T3 rectal carcinoma. Methods We retrospectively analyzed 175 patients with stage T3 rectal cancer who underwent preoperative MRI, including diffusion-weighted imaging (DWI) before surgery. 62 patients were included in the LNM group, and 113 patients were included in the non-LNM group. Texture features were calculated from histograms derived from T2 weighted imaging (T2WI), DWI, ADC, and T2 maps. Stepwise logistic regression analysis was used to screen independent predictors of LNM from clinical features, imaging features, and histogram features. Predictive performance was evaluated by receiver operating characteristic (ROC) curve analysis. Finally, a nomogram was established for predicting the risk of LNM. Results The clinical, imaging and histogram features were analyzed by stepwise logistic regression. Preoperative carbohydrate antigen 199 level (p = 0.009), MRN stage (p < 0.001), T2WIKurtosis (p = 0.010), DWIMode (p = 0.038), DWICV (p = 0.038), and T2-mapP5 (p = 0.007) were independent predictors of LNM. These factors were combined to form the best predictive model. The model reached an area under the ROC curve (AUC) of 0.860, with a sensitivity of 72.8% and a specificity of 85.5%. Conclusion The histogram features on multi-parametric MRI of the primary tumor in rectal cancer were related to LN status, which is helpful for improving the ability to predict LNM of stage T3 rectal cancer.
format	article
author	Yang Zhou Rui Yang Yuan Wang Meng Zhou Xueyan Zhou JiQing Xing Xinxin Wang Chunhui Zhang
author_facet	Yang Zhou Rui Yang Yuan Wang Meng Zhou Xueyan Zhou JiQing Xing Xinxin Wang Chunhui Zhang
author_sort	Yang Zhou
title	Histogram analysis of diffusion-weighted magnetic resonance imaging as a biomarker to predict LNM in T3 stage rectal carcinoma
title_short	Histogram analysis of diffusion-weighted magnetic resonance imaging as a biomarker to predict LNM in T3 stage rectal carcinoma
title_full	Histogram analysis of diffusion-weighted magnetic resonance imaging as a biomarker to predict LNM in T3 stage rectal carcinoma
title_fullStr	Histogram analysis of diffusion-weighted magnetic resonance imaging as a biomarker to predict LNM in T3 stage rectal carcinoma
title_full_unstemmed	Histogram analysis of diffusion-weighted magnetic resonance imaging as a biomarker to predict LNM in T3 stage rectal carcinoma
title_sort	histogram analysis of diffusion-weighted magnetic resonance imaging as a biomarker to predict lnm in t3 stage rectal carcinoma
publisher	BMC
publishDate	2021
url	https://doaj.org/article/60415aec794745b3805204f84b4a08a1
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Histogram analysis of diffusion-weighted magnetic resonance imaging as a biomarker to predict LNM in T3 stage rectal carcinoma

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