Discrimination of metastatic from non-metastatic mesorectal lymph nodes in rectal cancer using quantitative dynamic contrast-enhanced magnetic resonance imaging

Abstract

Preoperative detection of lymph nodes (LNs) metastasis is always highly challenging for radiologists nowadays. The utility of quantitative dynamic contrast-enhanced magnetic resonance imaging (QDCE-MRI) in identifying LNs metastasis is not well understood. In the present study, 59 patients with histologically proven rectal carcinoma underwent preoperative QDCE-MRI. The short axis diameter ratio, long axis diameter ratio, short-to-long axis diameter ratio and QDEC-MRI parameters (K^trans, K_ep, f_PV and V_e) values were compared between the non-metastatic (n=44) and metastatic (n=35) LNs groups based on pathological examination. Compared with the non-metastatic group, the metastatic group exhibited significantly higher short axis diameter (7.558±0.668 mm vs. 5.427±0.285 mm), K^trans (0.483±0.198 min^-1vs. 0.218±0.116 min^-1) and V_e (0.399±0.118 vs. 0.203±0.096) values (all P<0.05). The short-to-long axis diameter ratio, long axis diameter ratio, K_ep and f_PV values did not show significant differences between the two groups. In conclusion, our results showed that for LNs larger than 5 mm in rectal cancer, there are distinctive differences in the K^trans and V_e values between the metastatic and non-metastatic LNs, suggesting that QDCE-MRI may be potentially helpful in identifying LNs status.

Keywords

rectal cancer / lymph node / dynamic contrast-enhanced magnetic resonance imaging / quantitative analysis / sensitivity and specificity

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