Role of diffusion-weighted magnetic resonance imaging in detection of lymph node metastasis in rectal cancer

Theodor Bilharz Research Institute

Bibliographic Information

Authors: shimy R.M.; Aly A.M.; Elshishtawy S.A.; Hassan M.H.; Desouky S.H.I.; Hanna A.

Journal: Egyptian Journal of Radiology and Nuclear Medicine

Publisher: Springer Nature

Publication Date: 5 August 2024

Volume / Issue: Volume 55 / Issue 1

Article No.: 146

ISSN: 0378603X

DOI: 10.1186/s43055-024-01324-w

Scopus: View on Scopus

Document Type: Article

Access: All Open Access; Gold Open Access

Authors and Affiliations

shimy R.M., Radiology Department, Theodor Bilharz Research Institute, Giza, Egypt; Aly A.M., Radiology Department, Theodor Bilharz Research Institute, Giza, Egypt; Elshishtawy S.A., Radiology Department, Theodor Bilharz Research Institute, Giza, Egypt; Hassan M.H., Radiology Department, Theodor Bilharz Research Institute, Giza, Egypt; Desouky S.H.I., Radiology Department, Theodor Bilharz Research Institute, Giza, Egypt; Hanna A., Radiology Department, Theodor Bilharz Research Institute, Giza, Egypt

Abstract

Background: Rectal cancer is the most prevalent gastrointestinal tumor. Early diagnosis, accurate staging as well as early treatment are the keys for improving the five-year survival rate. The objective of this research is to assess the effectiveness of diffusion-weighted MRI (DWI) in identifying lymph nodes and distinguishing between benign and metastatic nodes throughout the first stage of primary rectal cancer. Results: The study showed that mean ADC value was significantly higher in mucinous carcinoma (1.72 ± 0.36 × 10–3 mm2/sec) than that in non-mucinous carcinoma (0.981 ± 0.276 × 10–3 mm2/sec) with a cutoff value of (1.3 × 10–3) mm2/s which was the precise value to produce high sensitivity, specificity and accuracy of 93%, 94%, and 94%, respectively. ADC analysis showed either intermediate or low signal in 49 (70%) and high signal in 21 (30%) L.Ns. Mean ADC value showed a significant reduction in malignant L.Ns (1.01 ± 0.54 × 10–3 mm2/sec) compared to benign L.Ns (1.51 ± 0.51 × 10–3 mm2/sec), AUC of 0.674 (P = 0.008) and a cutoff value of 0.987 × 10–3 mm2/s with sensitivity, specificity and accuracy of 44.4%, 91.2% and 67.5%, respectively. The mean L.N /tumor ratio was 1.65 ± 0.73 in benign L.Ns and 1.06 ± 0.37 in malignant L.Ns. Conclusions: In rectal cancer, there was a significant difference between benign and malignant L.Ns regarding diffusion result, L.Ns size, shape, and margin. The study demonstrated the effectiveness of DWI in diagnosing lymph node metastasis in colorectal cancer; true diffusion restriction was significantly noted in malignant L.Ns compared to benign L.Ns. Mean ADC value showed a significant reduction in malignant L.Ns compared to benign L.Ns. L.N/tumor ratio showed a significant reduction in malignant L.Ns compared to benign L.Ns. © The Author(s) 2024.

Keywords

Diffusion-weighted Images; Lymph Node metastasis; Rectal cancer; adult; aged; area under the curve; Article; cancer diagnosis; clinical article; colloid carcinoma; diffusion weighted imaging; female; human; male; receiver operating characteristic; rectum cancer; sensitivity and specificity; tumor volume; very elderly

Citation Information

Scopus Citations: 0

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