Diffusion kurtosis imaging in patients with locally advanced rectal cancer: current status and future perspectives

Abstract

Morphological magnetic resonance imaging is currently the best imaging technique for local staging in patients with rectal cancer. However, morphological sequences have some limitations, especially after preoperative chemoradiotherapy (pCRT). Diffusion-weighted imaging has been applied to rectal cancer for detection of lesions, characterization of tissue, and evaluation of the response to therapy. In 2005, a non-Gaussian diffusion model called diffusion kurtosis imaging (DKI) was suggested. Several electronic databases were evaluated in the present review. The search included articles published from January 2000 to May 2018. The references of all articles were also evaluated. All titles and abstracts were assessed, and only the studies of DKI in patients with rectal cancer were retained. We identified 35 potentially relevant references through the electronic search. According to the inclusion and exclusion criteria, we retained five clinical studies that met the inclusion criteria. DKI is a useful tool for assessment of tumor aggressiveness, the nodal status, and the risk of early metastases as well as prediction of the response to pCRT. The results of DKI should be considered in treatment decision-making during the work-up of patients with rectal cancer.

Endorectal Ultrasound and Magnetic Resonance Imaging for Rectal Cancer Staging: A Modern Multimodality Approach

“…These results underline the novel and important contribution that this technique could also provide for tumor staging. In particular, the opportunity to differentiate hypercellular tissues (neoplasm vs. inflammation) through the evaluation of ADC map represents a modern strategy that can assist in tumor depiction [15,16]. The evaluation of ERUS capabilities confirmed the excellent diagnostic value of this method in early rectal cancer assessment (stage T1) in our cases as well.…”

“…These recent therapeutic strategies have further increased the role of preoperative imaging for the assessment of tumor stage, especially for borderline tumors at high risk of staging failure. MRI is the standard technique for rectal cancer staging [ 12 , 13 , 14 , 15 ]. An additional imaging technique, such as diffusion weighted imaging (DWI), has demonstrated an important contribution in the assessment of rectal cancer.…”

“…Currently, DWI is the only noninvasive method able to detect diffuse movement of water molecules in living tissues, thus assessing tissue cellularity and integrity of cell membrane [ 16 , 17 ]. This technique has shown higher abilities in distinguishing tumor boundaries and in predicting tumor invasion than conventional MRI [ 11 , 13 , 15 , 16 , 17 ]. Endorectal ultrasonography (ERUS) is a reliable imaging method, able to evaluate rectal wall infiltration, especially for early tumors [ 4 , 18 , 19 , 20 , 21 ].…”

Abbreviated MRI protocol for colorectal liver metastases: How the radiologist could work in pre surgical setting

“…Functional data, extracted by diffusion weighted imaging (DWI) and dynamic contrast-enhanced (DCE)-MRI, allow a proper detection and characterization of focal liver lesions [5][6][7][8]. Oncology is a major field of application of DWI, especially in the detection and characterization of liver metastases [9][10][11]. The analysis of DW data can be done qualitatively and quantitatively, through the apparent diffusion coefficient (ADC) map, which is the graphical representation of the ratio of DW signal intensities and its measurements and it may discriminate between benign and malignant lesions.…”

Introduction to Special Issue of Radiology and Imaging of Cancer

“…Medical imaging comprises a huge number of imaging techniques, and multiple biomedical imaging techniques are used in all phases of cancer management because they are able to provide morphological and functional data [ 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 ]. In addition, image-guided invasive therapy has the promise to improve outcomes and reduce collateral effects compared to systemic or surgical treatment [ 20 , 21 ].…”