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Chen F, Zhang S, Ma X, Chen Y, Wang Z, Zhu Y, Bai C, Fu C, Grimm R, Shao C, Lu J, Shen F, Chen L. Prediction of tumor budding in patients with rectal adenocarcinoma using b-value threshold map. Eur Radiol 2023; 33:1353-1363. [PMID: 35997838 DOI: 10.1007/s00330-022-09087-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 07/28/2022] [Accepted: 08/04/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To investigate the feasibility of b-value threshold (bThreshold) map in preoperative evaluation of tumor budding (TB) in patients with locally advanced rectal cancer (LARC). METHODS Patients with LARC were enrolled and underwent diffusion-weighted imaging (DWI). Contrast-to-noise ratio (CNR) between the lesions and normal tissues was assessed using DWI and bThreshold maps. TB was counted and scored using hematoxylin and eosin staining. Reproducibility for the apparent diffusion coefficient (ADC), bThreshold values, and region-of-interest (ROI) sizes were compared. Differences in ADC and bThreshold values with low-intermediate and high TB grades and the correlations between mean ADC and bThreshold values with TB categories were analyzed. Diagnostic performance of ADC and bThreshold values was assessed using area under the curve (AUC) and decision curve analysis. RESULTS Fifty-one patients were evaluated. The CNR on bThreshold maps was significantly higher than that on DW images (9.807 ± 4.811 vs 7.779 ± 3.508, p = 0.005). Reproducibility was excellent for the ADC (ICC 0.933; CV 8.807%), bThreshold values (ICC 0.958; CV 7.399%), and ROI sizes (ICC 0.934; CV 8.425%). Significant negative correlations were observed between mean ADC values and TB grades and positive correlations were observed between mean bThreshold values and TB grades (p < 0.05). bThreshold maps showed better diagnostic performance than ADC maps (AUC, 0.914 vs 0.726; p = 0.048). CONCLUSIONS In LARC patients, bThreshold values could distinguish different TB grades better than ADC values, and bThreshold maps may be a preoperative, non-invasive approach to evaluate TB grades. KEY POINTS • Compared with diffusion-weighted images, bThreshold maps improved visualization and detection of rectal tumors. • Agreement and diagnostic performance of bThreshold values are superior to apparent diffusion coefficient in assessing tumor budding grades in patients with locally advanced rectal cancer. • bThreshold maps could be used to evaluate tumor budding grades non-invasively before operation.
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Affiliation(s)
- Fangying Chen
- Department of Radiology, Changhai Hospital, Naval Medical University, NO. 168 Changhai Road, Shanghai, 200433, China
| | - Shaoting Zhang
- Department of Radiology, Changhai Hospital, Naval Medical University, NO. 168 Changhai Road, Shanghai, 200433, China
| | - Xiaolu Ma
- Department of Radiology, Changhai Hospital, Naval Medical University, NO. 168 Changhai Road, Shanghai, 200433, China
| | - Yukun Chen
- Department of Radiology, Changhai Hospital, Naval Medical University, NO. 168 Changhai Road, Shanghai, 200433, China
| | - Zhen Wang
- Department of Radiology, Changhai Hospital, Naval Medical University, NO. 168 Changhai Road, Shanghai, 200433, China
| | - Yan Zhu
- Department of Pathology, Changhai Hospital, Shanghai, China
| | - Chenguang Bai
- Department of Pathology, Changhai Hospital, Shanghai, China
| | - Caixia Fu
- MR Application Development, Siemens Shenzhen Magnetic Resonance Ltd, Shenzhen, China
| | - Robert Grimm
- MR Applications Predevelopment, Siemens Healthineers Ltd., Erlangen, Germany
| | - Chengwei Shao
- Department of Radiology, Changhai Hospital, Naval Medical University, NO. 168 Changhai Road, Shanghai, 200433, China
| | - Jianping Lu
- Department of Radiology, Changhai Hospital, Naval Medical University, NO. 168 Changhai Road, Shanghai, 200433, China
| | - Fu Shen
- Department of Radiology, Changhai Hospital, Naval Medical University, NO. 168 Changhai Road, Shanghai, 200433, China.
| | - Luguang Chen
- Department of Radiology, Changhai Hospital, Naval Medical University, NO. 168 Changhai Road, Shanghai, 200433, China.
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