Value of Apparent Diffusion Coefficient for Assessing Preoperative T Staging of Low Rectal Cancer and Whether This Is Correlated With Ki-67 Expression

Abstract

Purpose: To explore the value of the apparent diffusion coefficient (ADC) in assessing preoperative T staging of low rectal cancer and the correlation between ADC value and Ki-67 expression. Methods: Data on 77 patients with a proven pathology of low rectal cancer were retrospectively analyzed. All patients underwent a magnetic resonance imaging scan 1 week prior to operation, and the mean ADC value was measured. All tumors were fully removed, and pathologic staging was determined. The Ki-67 expression was determined using immunohistochemical methods in all patients. The correlation between Ki-67 expression and ADC features was studied. Results: A total of 77 patients with low rectal cancer were included in the study. The pathology type was adenocarcinoma. The numbers of patients with pathological stages T1, T2, T3, and T4 were 9, 23, 32, and 13, respectively. The ADC value of all tumors ranged from 0.60 to 1.20 mm2/s. The average Ki-67 proliferation index was 55.3% ± 20.2%. A significant difference was observed between the preoperative ADC value and pathological T staging of low rectal cancer ( P < .01). The more advanced the T stage, the lower the detected ADC values were. A negative correlation was noted between the preoperative ADC value and Ki-67 proliferation index of rectal cancer ( r = −0.71, P < .01). When the Ki-67 proliferation index increased, lower ADC values were detected. Conclusion: The ADC values can provide useful information on preoperative tumor staging and may facilitate evaluation of the biological behavior of low rectal cancer. The ADC values should be considered a sensitive image biomarker of rectal cancer.

Apparent diffusion coefficient cannot discriminate metastatic and non-metastatic lymph nodes in rectal cancer: a meta-analysis

“…DWI also reflects different histopathological features in RC. In the study of Ao et al, ADC correlated well with Ki-67 (r = −0.71, p < 0.01) [ 33 ]. Meng et al showed that ADC correlated with expression of VEGF and HIF 1a [ 34 ].…”

Pretreatment Apparent Diffusion Coefficient Cannot Predict Histopathological Features and Response to Neoadjuvant Radiochemotherapy in Rectal Cancer: A Meta-Analysis

“…Relationships between different tumor stages and ADC values were reported in 6 studies (352 patients) [14,40,[43][44][45][46]. There were 29 patients (8.2%) with T1 stage, 141 patients (40.1%) with T2 stage, 145 patients (41.2%) with T3 stage, and 37 patients (10.5%) with T4 stage.…”

“…Figure 5b shows the graphical distribution of ADC values in N0 and N+ tumors. Ao 2020 [14] Peng 2018 [40] Sun 2014 [43] Tang 2018 [45] Xia 2018 [46] Subtotal (95% CI)…”

“…Ao 2020 [14] Peng 2018 [40] Sun 2014 [43] Surov 2017 [44] Tang 2018 [45] Xia 2018 [46] Subtotal (95% CI)…”

“…In 4 studies with 234 patients, associations between ADC and the proliferation marker Ki 67 were analyzed [14,38,43,44]. The calculated pooled correlation coefficient was −0.52, 95% CI (−0.69, −0.35) (Fig.…”