Value of multiple models of diffusion-weighted imaging to predict hepatic lymph node metastases in colorectal liver metastases patients

Table 1 Univariate and multivariate analysis of clinical and magnetic resonance imaging factors for prediction of hepatic lymph nodes metastases

		Univariate analysis			Multivariate analysis
		Non-hepatic LNM (n = 57)	hepatic LNM HLN (n = 40)	P value	OR (95%CI)	P value
Gender	Male/female	44/13	27/13	0.029a
Age		52.91 ± 10.48	57.53 ± 9.43	0.054
BMI		24.63 ± 3.04	24.50 ± 3.04	0.842
Primary location	Right/left-side	15/42	6/34	0.944
Differentiation	Low to moderate/High	55/2	40/0	0.510
T stage of primary tumor	T1+2/T3+4	3/54	4/36	0.650
N stage of primary tumor	N0/N+	9/48	5/35	0.149
Gene	RAS-wild/mutation	38/19	28/12	0.729
Simultaneous liver metastases	No/Yes	13/44	12/28	0.425
Distribution	Solitary/Bilateral	20/37	15/25	0.808
Number of CRLM	≤ 3/> 3	17/40	15/25	0.429
Size (mm)		38.25 ± 27.69	37.88 ± 22.11	0.944
RECIST	Response/Non-response	33/24	21/19	0.599
Disappearing lesion	No/Yes	46/11	34/6	0.584
pre-CEA	≤ 5/> 5 ng/mL	15/42	11/29	0.897
pre-CA199	≤ 40/> 40 U/mL	26/31	17/23	0.761
post-CEA	≤ 5/> 5 ng/mL	27/30	17/23	0.635
post-CA199	≤ 40/> 40 U/mL	33/24	25/15	0.649
Short axis of largest lymph node before treatment	mm	7.39 ± 2.65	11.88 ± 5.35	< 0.001a
Long axis of largest lymph node before treatment	mm	14.25 ± 6.41	18.28 ± 7.28	0.005a
Pre-ADC	mm2/s	1.54 ± 0.35	1.49 ± 0.30	0.394
Pre-D	mm2/s	1.21 ± 0.43	1.02 ± 0.25	0.005a
Pre-D*	mm2/s	3.33 ± 2.37	2.70 ± 2.38	0.200
Pre-f		0.49 ± 0.17	0.45 ± 0.14	0.330
Pre-DDC	mm2/s	3.21 ± 1.69	2.01 ± 0.83	< 0.001a	< 0.001	0.002a
Pre-α		0.59 ± 0.17	0.62 ± 0.16	0.363
Short axis of largest lymph node after treatment	mm	6.74 ± 2.13	10.43 ± 3.62	< 0.001a	1.509 (1.235-1.845)	< 0.001a
Long axis of largest lymph node after treatment	mm	13.46 ± 5.78	17.08 ± 6.82	0.006a
Post-ADC	mm2/s	1.64 ± 0.32	1.45 ± 0.32	0.006a
Post-D	mm2/s	1.35 ± 0.86	1.24 ± 0.78	0.529
Post-D*	mm2/s	3.69 ± 2.96	3.48 ± 3.38	0.751
Post-f		0.51 ± 0.18	0.52 ± 0.18	0.732
Post-DDC		3.46 ± 1.48	2.37 ± 0.91	< 0.001a
Post-α		0.61 ± 0.13	0.67 ± 0.13	0.035a

^aP values that are significantly different between metastatic and non-metastatic HLN group.

HLN: Hemolymph node; OR: Odds ratio; BMI: Body mass indices; CRLM: Colorectal liver metastases; RECIST: Response Evaluation Criteria In Solid Tumors; CEA: Carcinoembryonic antigen; CA19-9: Carbohydrate antigen 19-9; ADC: Apparent diffusion coefficient; CI: Confidence interval; DDC: Distributed diffusion coefficient; LNM: Lymph node metastases; D: True diffusion coefficient; D*: Pseudo-diffusion coefficient; f: The perfusion fraction; α: Intravoxel water diffusion heterogeneity.

Table 2 Diagnostic performance of quantitative parameters and nomogram in predicting hepatic lymph node metastases in colorectal liver metastases patient

	AUC	Cut off value	Sensitivity (%)	Specificity (%)	PPV (%)	NPV (%)	Accuracy (%)
Pre-ADC	0.551 (0.436-0.666)	1.70	32.5	82.5	56.5	63.5	61.5
Pre-D	0.648 (0.538-0.758)	1.15	55.0	77.2	62.9	58.1	68.0
Pre-D*	0.592 (0.477-0.707)	2.51	55.0	66.7	53.7	71.0	62.1
Pre-f	0.577 (0.462-0.692)	3.98	70.0	47.5	48.3	64.3	56.7
Pre-DDC	0.770 (0.676-0.865)	1.92	85.0	59.6	59.6	85.0	70.1
Pre-α	0.573 (0.456-0.689)	0.59	62.5	59.6	52.1	69.4	60.8
Post-ADC	0.664 (0.553-0.774)	1.46	75.0	52.6	52.6	75.0	61.9
Post-D	0.581 (0.447-0.681)	1.21	50.0	70.2	54.1	66.7	62.1
Post-D*	0.558 (0.438-0.678)	1.27	85.0	33.3	47.2	76.0	54.6
Post-f	0.521 (0.403-0.638)	3.98	77.5	31.6	44.3	66.7	50.5
Post-DDC	0.739 (0.641-0.838)	2.26	82.5	52.5	55.0	81.1	64.9
Post-α	0.623 (0.509-0.737)	0.65	57.5	70.2	57.5	70.2	65.0
Short axis of largest lymph node before treatment (mm)	0.773 (0.674-0.872)	12	50.0	94.7	87.0	73.0	76.3
Short axis of largest lymph node after treatment (mm)	0.811 (0.724-0.899)	10	52.5	94.7	38.9	74.0	77.3
Nomogram	0.873 (0.803, 0.943)	1.03	82.5	82.5	87.0	76.7	82.5

AUC: Area under the receiver operating characteristic curve; ADC: Apparent diffusion coefficient; NPV: Negative predictive value; PPV: Positive predictive value; DDC: Distributed diffusion coefficient; D: True diffusion coefficient; D*: Pseudo-diffusion coefficient; f: The perfusion fraction; α: Intravoxel water diffusion heterogeneity.