旨在探讨术前酰胺质子转移加权 (APTw) MRI 对评估直肠腺癌 (RA) 预后因素的价值。这项前瞻性研究于 2022 年 1 月至 2023 年 9 月进行，连续纳入接受术前酰胺质子转移加权 (APTw) MRI 治疗的 RA 参与者。手术 MRI 和根治性手术。通过Mann-Whitney U检验或t检验比较不同肿瘤（T）、淋巴结（N）分期、神经周围侵犯（PNI）和肿瘤分级的RA APTw信号强度（SI）值。受试者工作特征曲线用于评估 APTw SI 值的诊断性能。 共有 51 名参与者入组（平均年龄，58 岁±10 [标准差]，26 名男性）。 T1-T2期24例，PNI阳性9例。 T3-T4期肿瘤的APTw SI max、99th和95th值显着高于T1-T2期肿瘤；中位数（四分位距）（M (IQR)）为（4.0% (3.6-4.9%) vs 3.4% (2.9-4.3%), p = 0.017), (3.7% (3.2-4.1%) vs 3.2% (分别为 2.8-3.8%)、p = 0.013) 和 (3.3% (2.8-3.8%) vs 2.9% (2.3-3.5%)、p = 0.033)。这些指标在 PNI 组之间也存在显着差异，M (IQR) (4.5% (3.6-5.7%) vs 3.7% (3.2-4.2%)，p = 0.017)、(4.1% (3.4-4.8%) vs分别为 3.3% (3.0-3.9%), p = 0.022) 和 (3.7% (2.7-4.2%) vs 2.9% (2.6-3.5%), p = 0.045)。术前 APTw MRI 在以下方面具有潜在价值： RA 中 T 分期和 PNI 确定的评估。术前酰胺质子转移加权 MRI 为 RA 中 T 分期和 PNI 的无创评估提供了一种定量方法，有助于精确的治疗计划。APTw MRI 在 RA 中的疗效需求进一步调查。 T3-T4 阶段和 PNI 阳性 APTw 信号强度分别高于 T1-T2 和非 PNI。 APTw MRI 提供了一种评估 RA 中 T 分期和 PNI 的定量方法。© 2024。作者获得欧洲放射学会的独家许可。

To investigate the value of the pre-operative amide proton transfer-weighted (APTw) MRI to assess the prognostic factors in rectal adenocarcinoma (RA).This prospective study ran from January 2022 to September 2023 and consecutively enrolled participants with RA who underwent pre-operative MRI and radical surgery. The APTw signal intensity (SI) values of RA with various tumor (T), node (N) stages, perineural invasion (PNI), and tumor grade were compared by Mann-Whitney U-test or t-test. The receiver operating characteristic curve was used to evaluate the diagnostic performance of the APTw SI values.A total of 51 participants were enrolled (mean age, 58 years ± 10 [standard deviation], 26 men). There were 24 in the T1-T2 stage and 9 with positive PNI. The APTw SI max, 99th, and 95th values were significantly higher in T3-T4 stage tumor than in T1-T2; the median (interquartile range) (M (IQR)) was (4.0% (3.6-4.9%) vs 3.4% (2.9- 4.3%), p = 0.017), (3.7% (3.2-4.1%) vs 3.2% (2.8-3.8%), p = 0.013), and (3.3% (2.8-3.8%) vs 2.9% (2.3-3.5%), p = 0.033), respectively. These indicators also differed significantly between the PNI groups, with the M (IQR) (4.5% (3.6-5.7%) vs 3.7% (3.2-4.2%), p = 0.017), (4.1% (3.4-4.8%) vs 3.3% (3.0-3.9%), p = 0.022), and (3.7% (2.7-4.2%) vs 2.9% (2.6-3.5%), p = 0.045), respectively.Pre-operative APTw MRI has potential value in the assessment of T-staging and PNI determination in RA.Pre-operative amide proton transfer-weighted MRI provides a quantitative method for noninvasive assessment of T-staging and PNI in RA aiding in precision treatment planning.The efficacy of APTw MRI in RA needs further investigation. T3-T4 stage and PNI positive APTw signal intensities were higher than T1-T2 and non-PNI, respectively. APTw MRI provides a quantitative method for assessment of T staging and PNI in RA.© 2024. The Author(s), under exclusive licence to European Society of Radiology.