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• Clinical Article •
Application research of cellular microstructural parameters based on magnetic resonance in predicting lymph node metastasis and tumor deposit of rectal cancer
YI Siqi  LI Yanwan  CHEN Meining  ZHENG Ping  LI Hang  ZHOU Peng  DONG Xiaolei  CHEN Xiaoli 

DOI:10.12015/issn.1674-8034.2025.11.020.


[Abstract] Objective To evaluate the efficacy of rectal cancer cell microstructural parameters fitted by time-dependent diffusion magnetic resonance imaging (td-dMRI) in preoperative prediction of lymph node metastasis (LNM) and tumor deposit (TD).Materials and Methods A retrospective analysis was conducted on the imaging and clinical data of 88 patients with rectal cancer who underwent surgery in our hospital from December 2023 to March 2025. All patients received preoperative td-dMRI examinations. Using the IMPULSED model, cellular microstructural parameters and apparent diffusion coefficient (ADC) were extracted, including cell diameter (d), intracellular volume fraction (Vin), extracellular diffusion coefficient (Dex), cellularity, ADCOGSE25Hz/PGSE value, and ADCOGSE40Hz/PGSE value. The correlation between td-dMRI parameters and pathological results was verified. Based on postoperative pathological data, patients were divided into LNM-negative group (Neg-LNM, n = 40) and LNM-positive group (Pos-LNM, n = 48), as well as TD-negative group (Neg-TD, n = 70) and TD-positive group (Pos-TD, n = 18). Differences in microstructural parameters and ADC ratios between the groups were compared. Receiver operating characteristic (ROC) curves and logistic regression analysis were used to assess the diagnostic efficacy of single and combined models in predicting TD and LNM.Results There was a good correlation between td-dMRI parameters and pathological measurements (n = 16; all r > 0.70; all P < 0.05). In the Pos-LNM group, the d value of cancer cells and ADCOGSE25Hz/PGSE values were significantly higher than those in the Neg-LNM group (both P < 0.05), while cellularity was lower than that in the Neg-LNM group (P < 0.05). In the Pos-TD group, the d value and ADCOGSE25Hz/PGSE value were significantly higher than those in the Neg-TD group (both P < 0.05), and cellularity was lower than that in the Neg-TD group (P < 0.05). Univariate logistic regression analysis showed that d value and ADCOGSE25Hz/PGSE value could predict LNM and TD (all P < 0.05). Multivariate logistic regression analysis combining d and ADCOGSE25Hz/PGSE indicated that the combined model could predict LNM and TD (P < 0.05). The AUC values of the d value, ADCOGSE25Hz/PGSE value, and the combined indicator for predicting LNM and TD were all greater than 0.70.Conclusions The microstructural parameter d and ADC ratio based on td-dMRI have favorable clinical application potential in predicting LNM and TD.
[Keywords] rectal cancer；tumor deposit；lymph nodes metastatic；time-dependent diffusion magnetic resonance imaging；cellular microstructural parameters；apparent diffusion coefficient

YI Siqi1   LI Yanwan1, 2   CHEN Meining3   ZHENG Ping4   LI Hang5   ZHOU Peng1   DONG Xiaolei1   CHEN Xiaoli1*  

1 Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Department of Radiology of University of Electronic Science and Technology of China, Chengdu 610041, China

2 School of Medicine University of Electronic Science and Technology of China, Chengdu 610051, China

3 Siemens Healthcare Systems Co., Ltd. Chengdu Branch, Chengdu 610041, China

4 Department of Pathology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu 610041, China

5 Department of Radiology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu 610072, China

Corresponding author: CHEN X L, E-mail: xiaolichen20@163.com

Conflicts of interest   None.

Received  2025-09-02
Accepted  2025-10-28
DOI: 10.12015/issn.1674-8034.2025.11.020
DOI:10.12015/issn.1674-8034.2025.11.020.

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