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• Clinical Article •
The value of quantitative parameters of diffusion kurtosis imaging in preoperative prediction of tumor budding grade of rectal cancer
CHEN Anliang  XIE Suling  WANG Yue  DONG Deshuo  TIAN Shifeng  WEI Qiang  LIU Ailian 

Cite this article as: CHEN A L, XIE S L, WANG Y, et al. The value of quantitative parameters of diffusion kurtosis imaging in preoperative prediction of tumor budding grade of rectal cancer[J]. Chin J Magn Reson Imaging, 2025, 16(2): 59-64, 99. DOI:10.12015/issn.1674-8034.2025.02.009.


[Abstract] Objective To investigate the value of multiple quantitative parameters of magnetic resonance diffusion kurtosis imaging (DKI) in predicting tumor budding (TB) grade of rectal cancer.Materials and Methods Retrospective analysis of data from 113 patients with rectal adenocarcinoma who underwent preoperative 3.0 T MR examination and were confirmed by surgical pathology, including 75 patients in low-medium grade TB group and 38 patients in high grade TB group. The diffusion weighted imaging (DWI) and DKI quantitative parameter values of the lesions in two groups were recorded, including the apparent diffusion coefficient (ADC) value, fractional anisotropy (FA) value, mean diffusivity (MD) value, mean kurtosis (MK) value. The intra-class correlation coefficient (ICC) test was used to evaluate the measurement consistency of each parameter value between two observers. The independent samples t-test or Mann-Whitney U test was used to analyze the differences between the two groups of parameters, and the diagnostic performances of single parameter and combined parameters were evaluated through the receiver operating characteristic (ROC) curve. The DeLong test was used to compare the performance of each parameter.Results The agreement between the two observers for each parameter value was good (ICC > 0.75). The MK value of the low-medium grade group was 0.762 ± 0.127, which was lower than the high grade group with the value of 0.962 ± 0.120. The ADC and MD values of the low-medium grade groups were 1.157 (1.043, 1.317) × 10-3 mm2/s and (1.377 ± 0.265) μm2/ms, which were all higher than those of the high grade group with the value of 0.964 (0.869, 1.069) × 10-3 mm2/s and (1.114 ± 0.135) μm2/ms, respectively, the difference of each parameter was statistically significant (P < 0.05). There was no statistically significant difference in FA values between the two groups. The areas under the curve (AUC) of ADC, MD and MK values in predicting TB grade were 0.805, 0.816, 0.880, with the sensitivities of 73.7%, 92.1%, 76.3%, and the specificities of 78.7%, 68.0%, 86.7%, respectively. The diagnostic performance of MK value was better than ADC and MD values (P < 0.05). The AUC values of the combined parameters ranged from 0.826 to 0.881, and there was no statistically significant difference in AUC value compared to the MK value.Conclusions The DKI quantitative parameters MK and MD demonstrated significant utility in the non-invasive preoperative prediction of TB status in rectal cancer, thereby assisting clinicians in formulating tailored treatment strategies for patients.
[Keywords] rectal cancer；tumor budding；magnetic resonance imaging；diffusion kurtosis imaging；diffusion-weighted imaging

CHEN Anliang1, 2   XIE Suling3   WANG Yue1   DONG Deshuo1   TIAN Shifeng1, 2   WEI Qiang1   LIU Ailian1, 2*  

1 Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian 116011, China

2 Dalian Engineering Research Center for Artificial Intelligence in Medical Imaging, Dalian 116011, China

3 Department of Pathology, the First Affiliated Hospital of Dalian Medical University, Dalian 116011, China

Corresponding author: LIU A L, E-mail: cjr.liuailian@vip.163.com

Conflicts of interest   None.

Received  2024-09-09
Accepted  2025-02-10
DOI: 10.12015/issn.1674-8034.2025.02.009
Cite this article as: CHEN A L, XIE S L, WANG Y, et al. The value of quantitative parameters of diffusion kurtosis imaging in preoperative prediction of tumor budding grade of rectal cancer[J]. Chin J Magn Reson Imaging, 2025, 16(2): 59-64, 99. DOI:10.12015/issn.1674-8034.2025.02.009.

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