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ORIGINAL RESEARCH article

Front. Oncol.
Sec. Gastrointestinal Cancers: Colorectal Cancer
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1464183
This article is part of the Research Topic Cancer Biomarkers: Molecular Insights into Diagnosis, Prognosis, and Risk Prediction View all articles

Significance Of Apparent Diffusion Coefficient In Diagnosis Of Rectal Carcinoma

Provisionally accepted
Milica Šarošković Milica Šarošković 1Miloš Vuković Miloš Vuković 1,2*Stefan Stojanoski Stefan Stojanoski 1,2Milica Zorić Milica Zorić 1Nataša Prvulović Bunović Nataša Prvulović Bunović 1,2Milena Spirovski Milena Spirovski 1,2Igor Nosek Igor Nosek 1,2
  • 1 Faculty of Medicine, University of Novi Sad, Novi Sad, Vojvodina, Serbia
  • 2 Oncology Institute of Vojvodina, Sremska Kamenica, Serbia

The final, formatted version of the article will be published soon.

    The apparent diffusion coefficient (ADC) is a quantitative parameter that facilitates the detection and reliable differentiation of rectal cancer. MR differentiation between rectal carcinoma, post-radiation proctitis, and normal rectal wall with the ADC values and their correlation with the level of oncological markers and pathohistological characteristics of rectal carcinoma. Methods: The retrospective study performed at the Institute of Oncology of Vojvodina included 300 patients, 100 each with rectal cancer, post-radiation proctitis, and normal rectum. Mean ADC values were obtained by measuring the region of interest (ROI) of the rectal wall. Results: Rectal cancer showed lower ADC values (0.665 ± 0.086 x 10 -3 mm 2 /s) compared to both postradiation proctitis (1.648 ± 0.268 x 10 -3 mm 2 /s) and normal rectum (1.180 ± 0.110 x 10 -3 mm 2 /s) (p<0.001). No significant differences in ADC values were observed between different grades of rectal cancer (p=0.874; p>0.05), depending on the presence of metastases in the lymph nodes (p=0.357; p>0.05), different TN stage (p=0.196; p>0.05), local spread of the tumor (p=0.312; p>0.05), the presence of RAS mutation (p=0.829; p>0.05) and the value of oncological markers (p=0.923; p>0.05). ADC values below 1.013 x 10 -3 mm 2 /s with 100% sensitivity and 96% specificity indicate the presence of rectal cancer in relation to normal wall, with a positive predictive value of 96.1% and a negative of 100%. ADC values below 1.255 x 10 -3 mm 2 /s with 100% sensitivity and 95% specificity indicate rectal cancer in relation to post-radiation proctitis. ADC values above 1.339 x 10 -3 mm 2 /s with 87% sensitivity and 89% specificity indicate post-radiation proctitis in relation to normal wall. Discussion: The ADC is a useful marker in differentiating between rectal cancer, post-radiation proctitis and normal rectal wall with high sensitivity and specificity, but it cannot be used to distinguish the histological grades of rectal cancer, nor other pathohistological parameters.

    Keywords: DWI, ADC, rectal cancer, Proctitis, TNM, Lymph Nodes

    Received: 13 Jul 2024; Accepted: 13 Sep 2024.

    Copyright: © 2024 Šarošković, Vuković, Stojanoski, Zorić, Prvulović Bunović, Spirovski and Nosek. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Miloš Vuković, Faculty of Medicine, University of Novi Sad, Novi Sad, 21000, Vojvodina, Serbia

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