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• Clinical Article •
Microsatellite instability of rectal cancer based on magnetic resonance diffusion kurtosis imaging
WANG Lili  LEI Jiankai  LI Shenghu  CUI Yaqiong  WEI Zhaokun  SONG Xuhui  MA Jun  LI Daming  MA Xiaomei  JIA Yingmei  HUANG Gang 

WANG L L, LEI J K, LI S H, et al. Microsatellite instability of rectal cancer based on magnetic resonance diffusion kurtosis imaging[J]. Chin J Magn Reson Imaging, 2023, 14(8): 73-78. DOI:10.12015/issn.1674-8034.2023.08.012.


[Abstract] Objective To investigate the correlation between the microsatellite instability (MSI) status and each parameter of diffusion kurtosis image (DKI) in rectal cancer, and to provide imaging detection indicators for evaluating the MSI status before and after rectal cancer treatment.Materials and Methods Eighty eight patients with a pathologically definite diagnosis of rectal cancer were included for analysis. All patients underwent MRI examination within one week before radical resection of rectal cancer surgery. The examination sequence contained DKI imaging. The obtained data were imported into the dedicated software to acquire DKI parameters such as mean kurtosis (MK), axial kurtosis (Ka), radial kurtosis (Kr), mean diffusion (MD), axial diffusion (Da), radial diffusion (Dr), fractional anisotropy (FA), and postoperative pathobiological characteristics. These parameters were used for statistical analysis. Intra-class correlation coefficient was used to evaluate the measurement consistency between two observers. The Kolmogorov-Smirnov test was to assess the normal distribution of DKI parameters. Spearman correlation coefficient was employed to examine the correlation between each quantitative parameter of DKI and MSI and microsatellite stability (MSS). Spearman correlation coefficient was used to compare the correlation between each quantitative parameter of DKI and MSI and MSS. The ROC curve analysis was performed to analyze each parameter of DKI associated with the presence of MSI to observe its value in predicting MSI. The DeLong test was utilized to compare the statistical differences in the AUC of each parameter. P values less than 0.05 were considered statistically significant.Results The correlation coefficient values between MSI and the DKI parameters were as follows: 0.258 (95% CI: 0.122-0.386) for Da, 0.346 (95% CI: 0.191-0.476) for Dr, -0.276 (95% CI: -0.421--0.118) for Ka, and -0.260 (95% CI: -0.383--0.139) for MK. There was indeed a weak positive correlation observed between MSI and Da as well as Dr, while a weak negative correlation was found between Ka and MK. However, no significant correlation was observed between MSI and MD, FA, or Kr (P＞0.05). The AUC values for Da, Dr, Ka, and MK in diagnosing MSI in rectal cancer were 0.759 (95% CI: 0.654-0.865), 0.847 (95% CI: 0.749-0.945), 0.777 (95% CI: 0.651-0.902), and 0.758 (95% CI: 0.665-0.856), respectively. The corresponding cut-off values were 0.65, 0.68, 0.55, and 0.70.Conclusions There is a correlation between MSI status and DKI parameters in rectal cancer, and they have some predictive value for it. This correlation is expected to make DKI parameters an optional method for predicting MSI status.
[Keywords] rectal cancer；microsatellite instability；magnetic resonance imaging；diffusion kurtosis imaging

WANG Lili1   LEI Jiankai2   LI Shenghu3   CUI Yaqiong1   WEI Zhaokun1   SONG Xuhui1   MA Jun1   LI Daming1   MA Xiaomei1   JIA Yingmei1   HUANG Gang1*  

1 Department of Radiology, Gansu Provincial People's Hospital, Lanzhou 730000, China

2 Department of Radiology, Gaotai Traditional Chinese Medicine Hospital, Zhangye 734300, China

3 Department of Radiology, Wuxi Traditional Chinese Medicine Hospital, Wuxi 214000, China

Corresponding author: Huang G, E-mail: keen0999@163.com

Conflicts of interest   None.

ACKNOWLEDGMENTS Gansu Province Youth Fund Program Project (No. 20JR5RA143); Internal Fund of Gansu Provincial People's Hospital (No. 20GSSY4-45).
Received  2023-02-24
Accepted  2023-07-21
DOI: 10.12015/issn.1674-8034.2023.08.012
WANG L L, LEI J K, LI S H, et al. Microsatellite instability of rectal cancer based on magnetic resonance diffusion kurtosis imaging[J]. Chin J Magn Reson Imaging, 2023, 14(8): 73-78. DOI:10.12015/issn.1674-8034.2023.08.012.

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