Preoperative Prediction Of TN Staging Of Rectal Cancer By Multiparametric Magnetic Resonance Imaging

Purpose: This study aims to explore the quantitative parameters of Amide Proton Transfer magnetic resonance imaging combined with the image features of T2 Weighted Imaging,in predicting preoperative TN staging of rectal cancer.Materials and Methods: 115 patients with suspected rectal cancer were prospectively enrolled,APT-MRI,DWI,T2 WI and other sequences were scanned before surgery.The staging of the tumor was evaluated on T2 WI images by two experienced radiologists,and the largest layer of the lesion was delineated as the region of interest.Then,the region of interest was placed on the corresponding site of the lesion on APT-MRI and DWI images,and the mean APT weighted signal intensity(APTw SI),magnetization transfer(MT)and ADC values of the tumor were calculated.Postoperative pathological information was collected and patients were divided into p T1-2,PT3-4,p N0 and PN1-2 groups.Independent sample T test was used to compare the differences of parameters between t staging and N staging groups,and Logistic regression was used to calculate the predicted values of MT-T2 WI combined parameters.The parameters with statistical significance were analyzed by receiver operating characteristic curve.Results: The MT value of p T1-2 was lower than p T3-4(25.12±0.58 and 26.40±1.01,respectively;p<0.05).The MT value of p N0 was lower than that of p N1-2(25.43±0.87,26.66±0.92;p< 0.05).The differences in APTw SI and ADC between PT1-2 and PT3-4,p N0 and p N1-2 tumors were not statistically significant.The AUC,sensitivity and specificity of MT to distinguish T-stage tumors were 0.860,68.57% and 100.00%,respectively.The AUC,sensitivity and specificity of MT to distinguish N-stage tumors were 0.852,95.45% and 66.67%,respectively.The AUC,sensitivity and specificity of MT-T2 WI combined to distinguish T-stage tumors were 0.889,80.00% and 91.3%,respectively.The AUC,sensitivity and specificity of MT-T2 combined to distinguish N-stage tumors were 0.868,100.00%,and 63.89%,respectively.Conclusion: APT-MRI combined with T2 WI can improve the ability of MRI to predict preoperative TN staging of rectal cancer,and provide a reliable basis for the selection of treatment plan for rectal cancer patients.