Predicting lymphovascular invasion in rectal cancer - evaluating the performance of golden-angle radial sparse parallel MRI for rectal perfusion assessment

Q: What was the main goal of the study?

To test whether combining a dual-parameter approach (DWI plus either TWIST or GRASP perfusion) improves diagnostic performance for predicting pathological lymphovascular invasion in rectal cancer compared with using DWI alone.

Q: How were perfusion and diffusion parameters measured?

Influx forward volume transfer constant (Ktrans) and rate constant (Kep) were measured as perfusion parameters, and ADC values were measured by two researchers for both imaging sequences.

Q: Which technique provided higher diagnostic performance for pLVI prediction?

GRASP combined with ADC, using GRASP-acquired Ktrans, achieved higher diagnostic performance than diffusion parameters alone, while TWIST did not provide additional benefit.

Sep 24, 2026

Uploaded by River Wang

Dual-parameter functional MRI was evaluated for predicting pathological lymphovascular invasion (pLVI) in rectal cancer, comparing GRASP or TWIST combined with diffusion-weighted imaging (DWI) against single-parameter DWI. Pathologically confirmed patients (n=179) underwent measurement of perfusion (Ktrans, Kep) and apparent diffusion coefficient (ADC) by two researchers. Receiver operating characteristic analyses compared sequence-specific parameter pairs. GRASP-derived Ktrans combined with ADC improved diagnostic performance versus diffusion alone (0.91±0.03 vs 0.71±0.06, P<0.001), whereas TWIST did not add benefit. Results suggest GRASP Ktrans supports multiparametric MRI prediction of pLVI-positive disease.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages9

Reading Time23 min

AccessFree to download

Methods

Ethics statement

Patient inclusion

Perfusion and diffusion parameter measurement

ROC analysis for pLVI prediction

Comparative diagnostic performance results

[www. nature.com/scientificreports](www. nature.com/scientificreports) OPEN Predicting lymphovascular invasion in rectal cancer: evaluating the performance of golden‑angle radial sparse parallel MRI for rectal perfusion assessment Yingying Fan1, Meining Chen2, Hongyun Huang1 & Mi Zhou1* This study aims to determine whether the dual‑parameter approach combined with either time‑ resolved angiography with stochastic trajectories (TWIST) or golden‑angle radial sparse parallel (GRASP) and diffusion‑weighted imaging (DWI) has superior diagnostic performance in predicting pathological lymphovascular invasion (pLVI) rectal cancer when compared with traditional single‑ parameter evaluations using DWI alone. Patients with pathologically confirmed rectal cancer were enrolled. Perfusion (influx forward volume transfer constant [Ktrans] and rate constant [Kep]) and apparent diffusion coefficient (ADC) were measured by two researchers. For both sequences, areas under receiver operating characteristic (ROCs) to predict pLVI‑positive rectal cancer were compared. A total of 179 patients were enrolled in our study. A combined analysis of ADC and perfusion parameters (Ktrans) acquired with GRASP yielded a higher diagnostic performance compared with diffusion parameters alone (area under the curve, 0.91 ± 0.03 vs. 0.71 ± 0.06, P < 0.001); However, ADC with GRASP‑acquired Kep andADC with TWIST‑acquired perfusion parameters (Ktrans or Kep) did not offer any additional benefit. The Ktrans of the GRASP technique improved the diagnostic performance of multiparametric MRI to predict rectal cancers with pLVI‑positive. In contrast, TWIST did not achieve this effect. Colorectal cancer is one of the leading causes of cancer morbidity and mortality worldwide1. Several factors determine its prognosis, including differentiation grade, T stage, and lymphovascular invasion (LVI)2–4. LVI, defined as the infiltration of tumor cells into lymphatic or blood vessels at the periphery of invasive carcinoma5,6, has been widely recognized as a negative prognostic factor in rectal cancer7. Even so, LVI has not been included as an important parameter to consider before adjuvant chemotherapy in the National Comprehensive Cancer Network guidelines due to difficulty in determining it before adjuvant chemotherapy; it can only be postoperatively diagnosed by histopathology8. Thus, more evidence is needed to warrant the application of LVI in clinical decision-making. MR imaging has been used as an important technique for rectal cancer staging and estimates tumor vascular permeability on the basis of pharmacokinetic modeling of the tumor gadolinium concentration with respect to the plasma compartment9. Diffusion-weighted imaging (DWI) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) are functional MRI imaging techniques that yield qualitative and quantitative information and provide unique insights regarding tumor cellularity, the integrity of cell membranes, and microcirculation10, 11. It has been shown that quantitative DCE-MRI parameters and apparent diffusion coefficient (ADC) values correlate closely with histological grade12, 13, response to neoadjuvant chemoradiotherapy (CRT) and tumor prognostic factors14. However, the view-sharing time-resolved angiography with stochastic trajectories (TWIST) technique, due to its high acceleration, is prone to motion artifacts caused by bowel movement or patient motion, which may reduce the diagnostic accuracy of the examination15. In addition, its accuracy is also compromised by a mismatch 1Department of Radiology, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, No.32, West Second Section of First Ring Road, Qingyang District, Chengdu 610072, People’s Republic of China. 2MR Scientific Marketing, Siemens Healthineers, Shanghai, China. *email: [1152372320@qq.com](1152372320@qq.com) [www. nature.com/scientificreports/](www. nature.com/scientificreports/

FAQs

What was the main goal of the study?

To test whether combining a dual-parameter approach (DWI plus either TWIST or GRASP perfusion) improves diagnostic performance for predicting pathological lymphovascular invasion in rectal cancer compared with using DWI alone.

How were perfusion and diffusion parameters measured?

Influx forward volume transfer constant (Ktrans) and rate constant (Kep) were measured as perfusion parameters, and ADC values were measured by two researchers for both imaging sequences.

Which technique provided higher diagnostic performance for pLVI prediction?

GRASP combined with ADC, using GRASP-acquired Ktrans, achieved higher diagnostic performance than diffusion parameters alone, while TWIST did not provide additional benefit.

Sep 24, 2026

Uploaded by River Wang