The use of quantitative T1-mapping to identify cells and collagen fibers in rectal cancer

Jie Yuan; Qun Wen; Hui Wang; Jiaoyan Wang; Kun Liu; Songhua Zhan; Mengxiao Liu; Zhigang Gong; WenLi Tan

doi:10.3389/fonc.2023.1189334

The use of quantitative T1-mapping to identify cells and collagen fibers in rectal cancer

Front Oncol. 2023 Jul 20:13:1189334. doi: 10.3389/fonc.2023.1189334. eCollection 2023.

Authors

Jie Yuan¹, Qun Wen¹, Hui Wang¹, Jiaoyan Wang¹, Kun Liu², Songhua Zhan¹, Mengxiao Liu³, Zhigang Gong¹, WenLi Tan¹

Affiliations

¹ Department of Radiology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China.
² Department of Pathology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China.
³ MR Scientific Marketing, Diagnostic Imaging, Siemens Healthineers Ltd, Shanghai, China.

Abstract

Aim: This study aimed to explore the value of T1 mapping in assessing the grade and stage of rectal adenocarcinoma and its correlation with tumor tissue composition.

Methods: Informed consent was obtained from all rectal cancer patients after approval by the institutional review board. Twenty-four patients (14 women and 10 men; mean age, 64.46 years; range, 35 - 82 years) were enrolled in this prospective study. MRI examinations were performed using 3.0T MR scanner before surgery. HE, immunohistochemical, and masson trichrome-staining was performed on the surgically resected tumors to assess the degree of differentiation, stage, and invasion. Two radiologists independently analyzed native T1 and postcontrast T1 for each lesion, and calculated the extracellular volume (ECV) was calculated from T1 values. Intraclass correlation coefficient (ICC) and Bland-Altman plots were applied to analyze the interobserver agreement of native T1 values and postcontrast T1 values. Student's t-test and one-way analysis of variance (ANOVA) were used to test the differences between T1 mapping parameters and differentiation types, T and N stages, and venous and neural invasion. Pearson correlation coefficients were used to analyze the correlation of T1 mapping extraction parameters with caudal type homeobox 2 (CDX-2), Ki-67 index, and collagen expression.

Results: Both the native and postcontrast T1 values had an excellent interobserver agreement (ICC 0.945 and 0.942, respectively). Postcontrast T1 values indicated significant differences in venous invasion (t=2.497, p=0.021) and neural invasion (t=2.254, p=0.034). Pearson's correlation analysis showed a significant positive correlation between native T1 values and Ki-67 (r=-0.407, p=0.049). There was a significant positive correlation between ECV and collagen expression (r=0.811, p=.000) and a significant negative correlation between ECV and CDX-2 (r=-0.465, p=0.022) and Ki-67 (r=-0.549, p=0.005).

Conclusion: Postcontrast T1 value can be used to assess venous and neural invasion in rectal cancer. ECV measurements based on T1 mapping can be used to identify cells and collagen fibers in rectal cancer.

Keywords: T1 mapping; extracellular volume; magnetic resonance imaging; rectal cancer; tumor tissue composition.