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ORIGINAL RESEARCH article
Front. Physiol.
Sec. Computational Physiology and Medicine
Volume 15 - 2024 |
doi: 10.3389/fphys.2024.1444897
This article is part of the Research Topic Medical Knowledge-Assisted Machine Learning Technologies in Individualized Medicine Volume II View all 7 articles
A combined diagnostic model including middle rectal artery visualization for predicting lateral lymph node metastasis in rectal cancer
Provisionally accepted
Ning Wang
1*
Yiping Li
1*
Kun Lu
1*
Kaikai Wei
1
Shize Jia
2
Shuhong Fan
1*
Donglin Ren
1*
Yuanji Fu
1*
Zhimin Liu
1*- 1 The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- 2 Sun Yet san University, Guangzhou, China
Purpose: This study attempted to establish a combined diagnostic model encompassing visualization of the middle rectal artery (MRA) and other imaging features to improve the diagnostic efficiency of lateral lymph node (LLN) metastasis, which is crucial for clinical decision-making in rectal cancer.Method: One hundred eleven patients receiving bilateral or unilateral lymph node dissection were enrolled, and 140 cases of LLN status on a certain unilateral pelvic sidewall were selected. Enhanced computed tomography (CT) was used to determine whether MRA was visible. Multivariable regression was used to establish a diagnostic model combining MRA visualization with other imaging features to predict LLN metastasis. Receiver operating characteristic (ROC) curve and area under the ROC curve (AUC) were used to test the diagnostic efficacy for LLN metastasis. Ten-fold cross-validation was completed to internally validate the diagnostic model.Of the 140 LLNs harvested from 111 patients, 76 were positive and 64 were negative for metastases, respectively. The diagnostic model combining the MRA visualization and lymph node short diameter showed a greater efficiency than a single scale (AUC = 0.945, 95% confidence interval = 0.893-0.976, P < 0.001). The mean cross-validated AUC was 0.869 (95% confidence interval = 0.835-0.903).Our results establish a combined diagnostic model with the help of MRA visualization to yield a high diagnostic efficiency of LLN metastasis in rectal cancer.
Keywords: rectal cancer, Middle rectal artery, Lateral lymph node, computed tomography, diagnostic test
Received: 06 Jun 2024; Accepted: 18 Dec 2024.
Copyright: © 2024 Wang, Li, Lu, Wei, Jia, Fan, Ren, Fu and Liu. 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:
Ning Wang, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
Yiping Li, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
Kun Lu, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
Shuhong Fan, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
Donglin Ren, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
Yuanji Fu, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
Zhimin Liu, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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