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• Clinical Article •
IVIM, mDixon-Quant multiparameter quantitative imaging combined with blood cell parameters to assess Ki-67 expression levels in rectal cancer
ZHAO Yadi  LI Weilan  SONG Jian  ZHOU Wei  XUE Hui  LI Yuanjie  WANG Zhiqiang  XIE Zongyuan 

Cite this article as: ZHAO Y D, LI W L, SONG J, et al. IVIM, mDixon-Quant multiparameter quantitative imaging combined with blood cell parameters to assess Ki-67 expression levels in rectal cancer[J]. Chin J Magn Reson Imaging, 2024, 15(8): 145-151. DOI:10.12015/issn.1674-8034.2024.08.022.


[Abstract] Objective To investigate the application value of intravoxel incoherent motion (IVIM), mDixon‐Quant combined with blood cell parameters in evaluating Ki‐67 expression levels in rectal cancer.Materials and Methods Clinical routine blood count and imaging examination data of 50 patients with clinicopathologically confirmed rectal cancer were retrospectively analyzed. We measured IVIM parameters apparent diffusion coefficient (ADC), pure apparent diffusion coefficient (D), pseudo apparent diffusion coefficient (D*), perfusion fraction (f) and mDixon‐Quant parameters fat fraction (FF), R2*, T2* of the lesion. Independent sample t test or Mann‐Whitney U test was used to compare the differences in the parameters. The efficacy of single and combined parameters in predicting Ki-67 expression status in rectal cancer was evaluated by plotting receiver operating characteristic (ROC) curves and calculating the area under the curve (AUC). Spearman test was used to evaluate the relationship between statistically significant imaging and blood cell parameters between the two groups.Results R2* value, FF value, neutrophil to lymphocyte ratio (NLR), systemic immune inflammation index (SII), systemic inflammatory response index (SIRI) of the Ki‐67 high expression group were higher than those of the Ki-67 low expression group, ADC value, D value of the Ki-67 high expression group were lower than those of the Ki-67 low expression group, and the differences were all statistically significant (P<0.05). The AUC of ADC value, D value, R2* value, FF value, NLR, SII, SIRI, imaging association parameters (ADC+D+R2*+FF) and imaging combined with blood cell parameters (ADC+D+R2*+FF+NLR+SII+SIRI) for evaluating the Ki-67 expression status of rectal cancer were 0.691, 0.775, 0.739, 0.724, 0.784, 0.726, 0.718, 0.839 and 0.906, respectively. The diagnostic efficiency of imaging combined with blood cell parameters was significantly improved compared to single parameters. Spearman test showed a positive correlation between FF values and SII in the Ki‐67 high expression group, and the difference was statistically significant (r=0.525, P=0.012).Conclusions IVIM, mDixon‐Quant and blood cell parameters are effective in determining Ki‐67 expression levels in rectal cancer, and the imaging combined with blood cell parameters can significantly improve the effectiveness of differential diagnosis. Abnormal lipid metabolism in cancer leads to fat deposition within the tumor lesion, which may cause an inflammatory response to develop.
[Keywords] rectal cancer；magnetic resonance imaging；intravoxel incoherent motion；mDixon‐Quant；Ki‐67；blood cell parameters；lipid metabolism

ZHAO Yadi1   LI Weilan1   SONG Jian1   ZHOU Wei1   XUE Hui2   LI Yuanjie1   WANG Zhiqiang1   XIE Zongyuan1*  

1 Department of MRI, North China University of Science and Technology Affiliated Hospital, Tangshan 063000, China

2 Department of Hematology, North China University of Science and Technology Affiliated Hospital, Tangshan 063000, China

Corresponding author: XIE Z Y, E-mail: 93347795@qq.com

Conflicts of interest   None.

Received  2024-03-09
Accepted  2024-08-09
DOI: 10.12015/issn.1674-8034.2024.08.022
Cite this article as: ZHAO Y D, LI W L, SONG J, et al. IVIM, mDixon-Quant multiparameter quantitative imaging combined with blood cell parameters to assess Ki-67 expression levels in rectal cancer[J]. Chin J Magn Reson Imaging, 2024, 15(8): 145-151. DOI:10.12015/issn.1674-8034.2024.08.022.

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