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Clinical Article
Value of magnetic resonance imaging combined with diffusion-weighted MR tumor volumetry in the diagnosis of TN staging for rectal cancer
HU You-qiang  CHEN Chen  CHEN Yong  XIE Chao-lian  LI Yong  ZENG Nan-lin  CHEN Tian-wu  ZHANG Xiao-ming 

DOI:10.12015/issn.1674-8034.2017.03.010.


[Abstract] Objective: To investigate the value of magnetic resonance imaging (MRI) in the diagnosis of preoperative TN staging for rectal cancer and the correlation between diffusion-weighted MR tumor volumetry and TN staging.Materials and Methods: Between September 2014 and February 2016, 74 patients with histologically proven rectal cancer by the colonoscopic biopsy in our hospital was performed by pelvic 3.0 T MRI. We analyzed the preoperative MRI TN staging of rectal cancer diagnosis accuracy. Concordance between MRI TN staging of tumor and pathologic reporting was assessed by means of the Kappa statistic. The correlation between diffusion-weighted MR tumor volumetry and TN staging was analyzed by one-way analysis of variance.Results: The accurate rate for T-staging of rectal cancer using MRI was 87.8% (66/74). There was a good correlation between pathologic and MRI tumor staging (Kappa=0.78, P=0.000). The accurate rate for N-staging of rectal cancer using MRI was 66.2% (49/74). There was a poor correlation between pathologic and MRI tumor staging (Kappa=0.33, P=0.000). The tumor volume of rectal cancer at DWI in ≤T2, T3and T4 staging rectal cancer was (4145.13±718.00) mm3, (14939.73±3591.38) mm3 and (22714.76±4251.71) mm3. The tumor volume of rectal cancer at DWI in N0, N1 and N2 staging was (14367.15±6425.83) mm3, (17967.69±5259.88) mm3 and (19464.00±3588.77) mm3. The greater of the tumor volume, the higher of the T-staging of rectal cancer, and the discrepancies were statistically different (F=75.189, P=0.000). The discrepancies between tumor volume and N-stagings of rectal cancer were statistically different (F=3.545, P=0.034).Conclusions: MRI has a good concordance with pathologic T-staging of rectal cancer, and has a certain clinical value in the N-staging. DWI tumor volumetry contributes a lot to diagnosis of TN-staging of rectal cancer.
[Keywords] Rectal neoplasms;Adenocarcinoma;Magnetic resonance imaging;Diffusion-weighted imaging;Tumor volume;Staging

HU You-qiang Sichuan Key Laboratory of Medical Imaging and Department of Radiology, Affiliated Hospital, North Sichuan Medical College, Nanchong 637000, China

CHEN Chen Sichuan Key Laboratory of Medical Imaging and Department of Radiology, Affiliated Hospital, North Sichuan Medical College, Nanchong 637000, China

CHEN Yong Sichuan Key Laboratory of Medical Imaging and Department of Radiology, Affiliated Hospital, North Sichuan Medical College, Nanchong 637000, China

XIE Chao-lian Sichuan Key Laboratory of Medical Imaging and Department of Radiology, Affiliated Hospital, North Sichuan Medical College, Nanchong 637000, China

LI Yong Sichuan Key Laboratory of Medical Imaging and Department of Radiology, Affiliated Hospital, North Sichuan Medical College, Nanchong 637000, China

ZENG Nan-lin Sichuan Key Laboratory of Medical Imaging and Department of Radiology, Affiliated Hospital, North Sichuan Medical College, Nanchong 637000, China

CHEN Tian-wu Sichuan Key Laboratory of Medical Imaging and Department of Radiology, Affiliated Hospital, North Sichuan Medical College, Nanchong 637000, China

ZHANG Xiao-ming* Sichuan Key Laboratory of Medical Imaging and Department of Radiology, Affiliated Hospital, North Sichuan Medical College, Nanchong 637000, China

*Correspondence to: Zhang XM, E-mail: cjr.zhxm@vip.163.com

Conflicts of interest   None.

ACKNOWLEDGMENTS  This article was supported by the National Health and Family Planning Commission public welfare industry research under special funding No. 201402019
Received  2016-09-26
Accepted  2017-01-06
DOI: 10.12015/issn.1674-8034.2017.03.010
DOI:10.12015/issn.1674-8034.2017.03.010.

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