Li YX, Cai SL, Peng MY, Wang TX, Geng W, Ma YH. T2 magnetic resonance imaging combined with diffusion-weighted imaging for colon cancer lymph nodes. World J Gastrointest Surg 2025; 17(6): 103298 [DOI: 10.4240/wjgs.v17.i6.103298]
Corresponding Author of This Article
Yue-Hu Ma, MD, Chief Physician, Department of Imaging, Nanjing First Hospital, Nanjing Medical University, No. 68 Changle Road, Qinhuai District, Nanjing 210006, Jiangsu Province, China. mayuehu1976@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Yong-Xia Li, Sheng-Li Cai, Department of Imaging, Nanjing Pukou District Hospital of Traditional Chinese Medicine, Nanjing 211800, Jiangsu Province, China
Ming-Yang Peng, Tong-Xing Wang, Wen Geng, Yue-Hu Ma, Department of Imaging, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, Jiangsu Province, China
Author contributions: Li YX designed the research study; Cai SL, Peng MY, Wang TX, Geng W, and Ma YH performed the research; Li XS and Ma YH analyzed the data and wrote the manuscript; All the authors read and approve the final manuscript.
Institutional review board statement: This study was reviewed and approved by the Institutional Review Committee of Nanjing Pukou District Hospital of Traditional Chinese Medicine (No. NJ901547).
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrollment.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: No other available data.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yue-Hu Ma, MD, Chief Physician, Department of Imaging, Nanjing First Hospital, Nanjing Medical University, No. 68 Changle Road, Qinhuai District, Nanjing 210006, Jiangsu Province, China. mayuehu1976@163.com
Received: March 5, 2025 Revised: March 28, 2025 Accepted: April 29, 2025 Published online: June 27, 2025 Processing time: 86 Days and 4 Hours
Abstract
BACKGROUND
Colorectal cancer is a malignancy with a high risk of lymph node metastasis and poor prognosis, and thus requires an accurate diagnosis.
AIM
To assess the diagnostic value of combined magnetic resonance T2-weighted imaging (T2WI) and diffusion-weighted imaging (DWI) in colorectal cancer.
METHODS
We included 120 patients with suspected colorectal cancer who underwent magnetic resonance imaging. Surgical pathology was used as the gold standard for comparison. Combined T2WI and DWI showed higher diagnostic efficacy than either of the two methods used individually.
RESULTS
The combined method achieved 94.74% sensitivity, 95.45% specificity, 95.00% accuracy, 94.74% positive predictive value, and 95.45% negative predictive value in qualitative diagnosis. It showed 94.44% sensitivity, 95.00% specificity, 94.74% accuracy, 94.44% positive predictive value, and 95.00% negative predictive value in clinical staging. Finally, it showed 94.74% sensitivity, 94.59% specificity, 94.74% accuracy, 94.74% positive predictive value, and 94.59% negative predictive value in diagnosing lymph node metastasis. These results were highly consistent with that of the gold standard.
CONCLUSION
This study combined T2WI and DWI for accurate diagnosis of colorectal cancer, aiding clinical staging and lymph node metastasis assessment. This approach is promising for clinical application.
Core Tip: By synergizing T2-weighted imaging texture analysis with diffusion-weighted imaging and machine learning, this study achieves unprecedented diagnostic precision (area under the curve ≥ 0.92) for colorectal cancer lymph node metastasis, outperforming traditional imaging methods. The integration of synthetic double inversion recovery imaging further optimizes anatomical visualization, enabling more accurate T staging and extramural infiltration assessment. These innovations hold transformative potential for preoperative risk stratification and therapeutic planning in colorectal cancer.
