Purpose To evaluate the diagnostic potential of DW-MRI relative parameters for differentiation of rectal cancers with different Kirsten rat sarcoma viral oncogene homologue (KRAS) mutation status. Methods Fifty-one patients with rectal cancer underwent diffusion-weighted MR imaging with eight b values. ADCs (including Max-ADC, Min-ADC and Mean-ADC) and IVIM parameters (D, pure diffusion; f, perfusion fraction; D*, pseudodiffusion coefficient) were respectively calculated by mono- and bi-exponential analysis. Patients were stratified into two groups: KRAS wild type and mutant. The DW-MRI-derived parameters between the KRAS wild-type group and KRAS mutant group were compared using the Mann-Whitney U test. Receiver-operating characteristic (ROC) analysis of discrimination between KRAS wild-type and KRAS mutant rectal cancer was performed for the DW-MRI-derived parameters. Results Max-ADC, Mean-ADC and D values were significantly lower in the KRAS mutant group than in the KRAS wild-type group, whereas a higher D* value was demonstrated in the KRAS mutant group. According to the ROC curve, Mean-ADC and D* values showed moderate diagnostic significance with the AUC values of 0.756 and 0.710, respectively. The cut-off values for -3 2 -3 2 Mean-ADC and D* were 1.43 × 10 mm /s and 26.58 × 10 mm /s, respectively. Conclusion Rectal cancers had distinctive
European Radiology – Springer Journals
Published: Feb 15, 2018
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