Abstract
PurposeTo compare the imaging quality, T stage and extramural venous invasion (EMVI) evaluation between the conventional and synthetic T2-weighted imaging (T2WI), and to investigate the role of quantitative values obtained from synthetic magnetic resonance imaging (MRI) for assessing nodal staging in rectal cancer (RC).MethodsNinety-four patients with pathologically proven RC who underwent rectal MRI examinations including synthetic MRI were retrospectively recruited. The image quality of conventional and synthetic T2WI was compared regarding signal-to-noise ratio (SNR), contrast-to-noise (CNR), sharpness of the lesion edge, lesion conspicuity, absence of motion artifacts, and overall image quality. The accuracy of T stage and EMVI evaluation on conventional and synthetic T2WI were compared using the Mc-Nemar test. The quantitative T1, T2, and PD values were used to predict the nodal staging of MRI-evaluated node-negative RC.ResultsThere were no statistically significant differences between conventional and synthetic T2WI in SNR, CNR, overall image quality, lesion conspicuity, and absence of motion artifacts (p = 0.058–0.978). There were no significant differences in the diagnostic accuracy of T stage and EMVI between conventional and synthetic T2WI from two observers (p = 0.375 and 0.625 for T stage; p = 0.625 and 0.219 for EMVI). The T2 value showed good diagnostic performance for predicting the nodal staging of RC with the area under the receiver operating characteristic, sensitivity, specificity, and accuracy of 0.854, 90.0%, 71.4%, and 80.3%, respectively.ConclusionsSynthetic MRI may facilitate preoperative staging and EMVI evaluation of RC by providing synthetic T2WI and quantitative maps in one acquisition.
Highlights
Colorectal cancer is the third most common malignancy worldwide, ranking third in mortality among female and male, respectively [1]
18 participants with suspicious metastatic lymph node on preoperative Magnetic resonance imaging (MRI) were excluded from quantitative evaluation of nodal staging
We preliminarily investigated the feasibility of using synthetic MRI for the preoperative evaluation of Rectal cancer (RC)
Summary
Colorectal cancer is the third most common malignancy worldwide, ranking third in mortality among female and male, respectively [1]. Rectal cancer (RC) accounts for approximately 30%–35% of colorectal cancer cases, which are mostly adenocarcinoma [2]. Besides the conventional contrast-weighted imaging, quantitative relaxation mappings have been shown to play a certain role in identifying the tumor grade, metastatic lymph nodes, lymphovascular invasion, and therapeutic response of several tumors [5,6,7,8,9]. The separate acquisitions of quantitative mappings and contrast-weighted images can be time-consuming. Synthetic MRI, in which a multi-echo and multi-delay acquisition scheme is adopted, can be advantageous of shorting scanning time by simultaneously quantifying T1, T2 and proton density (PD) relaxometry and generating synthetic contrast-weighted images in a single scan [10, 11]
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