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This study was aimed to determine the diagnostic performance of perfusion-related parameters derived from intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) by comparing them with quantitative parameters from dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) based on differentiation grades of rectal cancer. We retrospectively analyzed 98 patients with rectal cancer. Perfusion-related IVIM parameters ( D  ∗ ,  f , and  f · D  ∗ ) and quantitative DCE parameters ( K  trans ,  K  ep ,  V   e  , and  V   p  ) were obtained by plotting the volume-of-interest on in-house software. Furthermore, we compared the difference and diagnostic performance of all well-moderately and poorly differentiated rectal cancer parameters. Finally, we analyzed the correlation between those DCE and IVIM parameters and pathological differentiation grade. The values of  f ,  K  trans , and  K  ep  significantly differentiated poor and well-moderate rectal cancers.  K  trans  achieved the highest area under the curve (AUC) value compared to perfusion-related IVIM and DCE parameters. Furthermore,  K  trans  showed a better correlation with pathological differentiation grade than  f . The diagnostic efficiency of DCE-MRI was greater than perfusion-related IVIM parameters. The  f  value derived from perfusion-related IVIM offered a diagnostic performance similar to DCE-MRI for patients with renal insufficiency.

Comparison of Diagnostic Performance between Perfusion-Related Intravoxel Incoherent Motion DWI and Dynamic Contrast-Enhanced MRI in Rectal Cancer