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Diffusion kurtosis imaging in identifying the malignancy of lymph nodes during the primary staging of rectal cancer
Author(s) -
Yu J.,
Dai X.,
Zou H.H.,
Song J.C.,
Li Y.,
Shi H.B.,
Xu Q.,
Shen H.
Publication year - 2018
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/codi.13835
Subject(s) - medicine , lymph , colorectal cancer , receiver operating characteristic , effective diffusion coefficient , kurtosis , malignancy , rectum , radiology , adenocarcinoma , rectal carcinoma , metastasis , cancer , pathology , magnetic resonance imaging , surgery , statistics , mathematics
Abstract Aim The aim was to assess the diagnostic value of diffusion kurtosis imaging ( DKI ) for discriminating between benign and malignant lymph nodes in patients with rectal carcinoma. Method ighty‐five patients with rectal adenocarcinoma who underwent total mesorectal excision of the rectum were studied. A total of 273 lymph nodes were harvested and subjected to histological analysis. Quantitative parameters [apparent diffusion parameter D app of the Gaussian distribution, apparent kurtosis coefficient K app and apparent diffusion coefficient ( ADC )] of lymph nodes were derived from DKI . Differences and the diagnostic performance of these parameters were calculated by using the independent‐samples t test and receiver operating characteristic curve analyses. Results The median D app and ADC values of metastatic lymph nodes were significantly greater than those of benign lymph nodes, whereas the median K app of metastatic lymph nodes was statistically less than that of normal lymph nodes. D app had the relatively highest area under the curve of 0.774. When 1126.15 × 10 −6 mm 2 /s was used as a D app threshold value, the sensitivity and specificity were 96.97% and 41.82%, respectively. Conclusion DKI can help differentiate metastatic vs benign lymph nodes during the primary staging of rectal cancer.