Ultra-high b-value DWI in rectal cancer: image quality assessment and regional lymph node prediction based on radiomics.

IF 4.7 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Radiology Pub Date : 2025-01-01 Epub Date: 2024-07-12 DOI:10.1007/s00330-024-10958-3

Yongfei Hao, Jianyong Zheng, Wanqing Li, Wanting Zhao, Jianmin Zheng, Hong Wang, Jialiang Ren, Guangwen Zhang, Jinsong Zhang

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引用次数: 0

Abstract

Objectives: This study aims to evaluate image quality and regional lymph node metastasis (LNM) in patients with rectal cancer (RC) on multi-b-value diffusion-weighted imaging (DWI).

Methods: This retrospective study included 199 patients with RC who had undergone multi-b-value DWI. Subjective (five-point Likert scale) and objective assessments of quality images were performed on DWI_b1000, DWI_b2000, and DWI_b3000. Patients were randomly divided into a training (n = 140) or validation cohort (n = 59). Radiomics features were extracted within the whole volume tumor on ADC maps (b = 0, 1000 s/mm²), DWI_b1000, DWI_b2000, and DWI_b3000, respectively. Five prediction models based on selected features were developed using logistic regression analysis. The performance of radiomics models was evaluated with a receiver operating characteristic curve, calibration, and decision curve analysis (DCA).

Results: The mean signal intensity of the tumor (SI_tumor), signal-to-noise ratio (SNR), and artifact and anatomic differentiability score gradually were decreased as the b-value increased. However, the contrast-to-noise (CNR) on DWI_b2000 was superior to those of DWI_b1000 and DWI_b3000 (4.58 ± 0.86, 3.82 ± 0.77, 4.18 ± 0.84, p < 0.001, respectively). The overall image quality score of DWI_b2000 was higher than that of DWI_b3000 (p < 0.001) and showed no significant difference between DWI_b1000 and DWI_b2000 (p = 0.059). The area under curve (AUC) value of the radiomics model based on DWI_b2000 (0.728) was higher than conventional ADC maps (0.690), DWI_b1000 (0.699), and DWI_b3000 (0.707), but inferior to multi-b-value DWI (0.739) in predicting LNM.

Conclusion: DWI_b2000 provides better lesion conspicuity and LNM prediction than DWI_b1000 and DWI_b3000 in RC.

Clinical relevance statement: DWI_b2000 offers satisfactory visualization of lesions. Radiomics features based on DWI_b2000 can be applied for preoperatively predicting regional lymph node metastasis in rectal cancer, thereby benefiting the stratified treatment strategy.

Key points: Lymph node staging is required to determine the best treatment plan for rectal cancer. DWI_b2000 provides superior contrast-to-noise ratio and lesion conspicuity and its derived radiomics best predict lymph node metastasis. DWI_b2000 may be recommended as the optimal b-value in rectal MRI protocol.

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直肠癌中的超高 b 值 DWI：基于放射组学的图像质量评估和区域淋巴结预测。

研究目的本研究旨在评估直肠癌（RC）患者多 b 值弥散加权成像（DWI）的图像质量和区域淋巴结转移（LNM）情况：这项回顾性研究纳入了 199 名接受多 b 值 DWI 检查的直肠癌患者。对 DWIb1000、DWIb2000 和 DWIb3000 的图像质量进行了主观（五点 Likert 量表）和客观评估。患者被随机分为训练组（n = 140）或验证组（n = 59）。分别在 ADC 图（b = 0、1000 s/mm2）、DWIb1000、DWIb2000 和 DWIb3000 上提取整个容积肿瘤的放射组学特征。利用逻辑回归分析建立了基于所选特征的五个预测模型。通过接收者操作特征曲线、校准和决策曲线分析（DCA）对放射组学模型的性能进行了评估：随着 b 值的增加，肿瘤的平均信号强度（SItumor）、信噪比（SNR）以及伪影和解剖可分辨性评分逐渐降低。然而，DWIb2000的对比度-噪声（CNR）优于DWIb1000和DWIb3000（4.58±0.86，3.82±0.77，4.18±0.84，p b2000高于DWIb3000（p b1000和DWIb2000（p = 0.059））。基于DWIb2000的放射组学模型的曲线下面积（AUC）值（0.728）高于传统ADC图（0.690）、DWIb1000（0.699）和DWIb3000（0.707），但在预测LNM方面不如多b值DWI（0.739）：结论：与 DWIb1000 和 DWIb3000 相比，DWIb2000 在 RC 中提供了更好的病灶清晰度和 LNM 预测能力：DWIb2000能令人满意地显示病变。基于 DWIb2000 的放射组学特征可用于术前预测直肠癌的区域淋巴结转移，从而有利于分层治疗策略：要点：淋巴结分期是确定直肠癌最佳治疗方案的必要条件。DWIb2000具有卓越的对比度-噪声比和病灶清晰度，其衍生的放射组学可最好地预测淋巴结转移。建议将 DWIb2000 作为直肠 MRI 方案的最佳 b 值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Radiology 医学-核医学

CiteScore

11.60

自引率

8.50%

发文量

874

审稿时长

2-4 weeks

期刊介绍： European Radiology (ER) continuously updates scientific knowledge in radiology by publication of strong original articles and state-of-the-art reviews written by leading radiologists. A well balanced combination of review articles, original papers, short communications from European radiological congresses and information on society matters makes ER an indispensable source for current information in this field. This is the Journal of the European Society of Radiology, and the official journal of a number of societies. From 2004-2008 supplements to European Radiology were published under its companion, European Radiology Supplements, ISSN 1613-3749.