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23 November 2021 : Database Analysis  

[In Press] Diffusion-Weighted Magnetic Resonance Imaging of 103 Patients with Rectal Adenocarcinoma Identifies the Apparent Diffusion Coefficient as an Imaging Marker for Tumor Invasion and Regional Lymph Node Involvement

Jaromir Kargol1ABCDEF, Wojciech Rudnicki2CDE, Jakub Kenig3DE, Justyna Filipowska4BE, Ewa Kaznowska5BE, Tomasz Kluz6BE, Wiesław Guz4BE, Elżbieta Łuczyńska4ACDEF

DOI: 10.12659/MSM.934941

Med Sci Monit In Press; DOI: 10.12659/MSM.934941  

Available online: 2021-11-23, In Press, Corrected Proof

Publication in the "In-Press" formula aims at speeding up the public availability of the pending manuscript while waiting for the final publication. The assigned DOI number is active and citable. The availability of the article in the Medline, PubMed and PMC databases as well as Web of Science will be obtained after the final publication according to the journal schedule


This retrospective study included 103 patients diagnosed with rectal adenocarcinoma at a single center in Poland who underwent preoperative diffusion-weighted magnetic resonance imaging (DWI) and aimed to determine whether the apparent diffusion coefficient (ADC) was an imaging marker for tumor invasion and regional lymph node involvement.
We analyzed primary staging magnetic resonance examinations of the rectum of 103 consecutive patients with histologically proven non-mucinous adenocarcinoma who underwent surgical treatment. In 85 patients, surgery was preceded by long-course chemoradiotherapy (n=18) or short-course radiotherapy (n=67). The following DWI parameters were measured: ADC mean, minimum, maximum, and standard deviation in the region of interest (ADC SD-in-ROI). Values were compared between subgroups based on histological parameters from the report: tumor stage, lymph node stage, differentiation grade, the presence of extranodal tumor deposits, angioinvasion, and perineural invasion. Statistical analysis was performed using the Mann-Whitney U test and the unilateral t test.
ADC mean values were lower for cases in which postoperative histopathological examination lymph node invasion (P=0.04) and tumor deposits were found (P=0.04). Minimal ADC value was higher in cases in which tumor deposits were not found (P=0.009). ADC SD-in-ROI values were lower in cases in which lymph nodes invasion was confirmed (P=0.014). There were no statistically significant differences for other parameters.
The ADC values in pre-treatment DWI in patients with rectal adenocarcinoma were correlated with tumor invasion and regional lymph node metastases. Therefore, ADC values from the pre-treatment MRI may help plan adjuvant therapy in patients with rectal adenocarcinoma.

Keywords: Diffusion Magnetic Resonance Imaging; Rectal Neoplasms; Biomarkers, Tumor


01 December 2021 : Editorial  

Editorial: SARS-CoV-2 Vaccine Responses and Breakthrough COVID-19

Dinah V. Parums
Scientific Editor, Medical Science Monitor, International Scientific Information, Inc., Melville, NY, USA

DOI: 10.12659/MSM.935624

Med Sci Monit 2021; 27:e935624


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Med Sci Monit In Press; DOI: 10.12659/MSM.934102  

01 December 2021 : Editorial  

Editorial: SARS-CoV-2 Vaccine Responses and Breakthrough COVID-19

Med Sci Monit 2021; 27:e935624

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Med Sci Monit In Press; DOI: 10.12659/MSM.934117  

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Med Sci Monit In Press; DOI: 10.12659/MSM.933942  

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Med Sci Monit In Press; DOI: 10.12659/MSM.934558  

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750