Guo LH, Qin W, Ou-Yang XH, Wang YX. Quantitative evaluation for preoperative clinical stage of colorectal cancer using dynamic contrast-enhanced magnetic resonance imaging. World J Gastrointest Surg 2025; 17(11): 109361 [DOI: 10.4240/wjgs.v17.i11.109361]
Corresponding Author of This Article
Ye-Xing Wang, Department of General Surgery, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, No. 7 Zhongyuan Road, Xiangyang 441003, Hubei Province, China. wangyexing1987@126.com
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Imaging Science & Photographic Technology
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Retrospective Study
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Nov 27, 2025 (publication date) through Nov 25, 2025
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World Journal of Gastrointestinal Surgery
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Guo LH, Qin W, Ou-Yang XH, Wang YX. Quantitative evaluation for preoperative clinical stage of colorectal cancer using dynamic contrast-enhanced magnetic resonance imaging. World J Gastrointest Surg 2025; 17(11): 109361 [DOI: 10.4240/wjgs.v17.i11.109361]
World J Gastrointest Surg. Nov 27, 2025; 17(11): 109361 Published online Nov 27, 2025. doi: 10.4240/wjgs.v17.i11.109361
Quantitative evaluation for preoperative clinical stage of colorectal cancer using dynamic contrast-enhanced magnetic resonance imaging
Li-Hong Guo, Wei Qin, Xin-Hua Ou-Yang, Ye-Xing Wang
Li-Hong Guo, Wei Qin, Xin-Hua Ou-Yang, Ye-Xing Wang, Department of General Surgery, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang 441003, Hubei Province, China
Co-first authors: Li-Hong Guo and Wei Qin.
Co-corresponding authors: Xin-Hua Ou-Yang and Ye-Xing Wang.
Author contributions: Guo LH and Qin W designed the research and wrote the first manuscript, they contributed equally to this article, they are the co-first authors of this manuscript; Guo LH, Qin W, Ou-Yang XH, and Wang YX contributed to conceiving the research and analyzing data; Ou-Yang XH and Wang YX contributed equally to this article, they are the co-corresponding authors of this manuscript; Guo LH and Qin W conducted the analysis and provided guidance for the research; and all authors reviewed and approved the final manuscript.
Institutional review board statement: This study was approved by the Medical Ethics Committee of Xiangyang Central Hospital.
Informed consent statement: The written informed consent was waived owing to the retrospective and deidentified nature of this study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The data that support the results of this research is available on request from the corresponding author.
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: Ye-Xing Wang, Department of General Surgery, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, No. 7 Zhongyuan Road, Xiangyang 441003, Hubei Province, China. wangyexing1987@126.com
Received: July 1, 2025 Revised: August 26, 2025 Accepted: October 11, 2025 Published online: November 27, 2025 Processing time: 146 Days and 19.7 Hours
Abstract
BACKGROUND
The management of patients with colorectal cancer (CRC) mainly lies on the use of magnetic resonance imaging (MRI) technique as a diagnostic tool for both staging and restaging.
AIM
To explore the preoperative value of quantitative parameters of dynamic contrast-enhanced MRI (DCE-MRI) in evaluating clinical stages of CRC.
METHODS
A total of 86 CRC patients undergoing DCE-MRI examinations were included and then classified into CRC group (n = 46) and benign tumor group (n = 40) according to surgical and pathological results. Quantitative parameters of DCE-MRI, including volume transfer constant (Ktrans), rate constant (Kep) and extravascular extracellular volume fraction (Ve), were analyzed between two groups and among CRC at different stages. Receiver operating characteristic (ROC) curves with of quantitative parameters of DCE-MRI for clinical diagnosis and preoperative staging of CRC were plotted.
RESULTS
The CRC group had 9 cases with tumor in the upper segment, 21 cases in the middle segment, 16 in the low segment, 10 cases with well differentiation, 27 cases with moderate differentiation, and 9 cases with poor differentiation. The Ktrans, Kep, and Ve in the CRC group were higher than those in the benign tumor group (P < 0.05). The ROC curves indicated that the optimal cutoff values of Ktrans, Kep and Ve for diagnosing CRC were 0.905 minute-1, 0.225 minute-1 and 0.585%, respectively. The Ktrans, Kep and Ve as a combined tool to diagnose CRC yielded 0.863 of area under the curve and 82.60% of sensitivity, and both values were higher than those yielded by Ktrans, Kep, or Ve alone (P < 0.05). The Ktrans, Kep and Ve in CRC patients at T3-T4 stage or N1-N2 stage were higher than those at T1-T2 stage or N0 stage (P < 0.05). Results of Spearman correlation analysis showed that the Ktrans, Kep and Ve were correlated with advanced T and N stages in CRC patients (P < 0.05). The ROC results indicated that the Ktrans produced a higher specificity (81.48%) and sensitivity (94.70%) in evaluating preoperative T stage of CRC. The Kep generated a higher specificity (96.00%) and sensitivity (81.00%) in evaluating preoperative N stage of CRC.
CONCLUSION
The study suggests that the values of Ktrans, Kep and Ve of DCE-MRI exhibit good performance in diagnosing CRC and preoperative assessment of clinical stages. However, relatively small sample size should be considered for data interpretation.
Core Tip: Patients with colorectal cancer exhibited higher values of quantitative parameters [volume transfer constant (Ktrans), rate constant (Kep) and extravascular extracellular volume fraction (Ve)] of dynamic contrast-enhanced magnetic resonance imaging than those with benign tumor. Increased values of Ktrans, Kep, and Ve were correlated with more advanced primary tumor and lymph node stages. The values of Ktrans, Kep and Ve exhibited good performance in diagnosing colorectal cancer and preoperative assessment of clinical stages.
