Retrospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. May 15, 2025; 17(5): 103809
Published online May 15, 2025. doi: 10.4251/wjgo.v17.i5.103809
Comparison of dynamic contrast-enhanced-magnetic resonance imaging parameters and serum markers in preoperative rectal cancer evaluation: Combined diagnostic value
Qun Wang, Xin-Yu Zhang, Jing-Fei Yang, Yi-Lei Tao
Qun Wang, Xin-Yu Zhang, Jing-Fei Yang, Yi-Lei Tao, Department of Radiology, The First People’s Hospital of Jiashan, Jiaxing 314000, Zhejiang Province, China
Co-first authors: Qun Wang and Xin-Yu Zhang.
Author contributions: Wang Q and Zhang XY jointly conceptualized and designed the research, conducted data analyses, and drafted the manuscript; Yang JF and Tao YL were primarily responsible for data collection and preprocessing, and assisted in data analysis and discussion; All authors reviewed and edited the manuscript; Wang Q and Zhang XY are co-first authors, and Wang Q serves as the corresponding author, overseeing the overall coordination and supervision of the project.
Institutional review board statement: This study was approved by the Medical Ethics Committee of The First People’s Hospital of Jiashan, Zhejiang Province, with the approval number 2024 Research Ethics Approval No. 097. All procedures followed in this study were in accordance with the ethical standards of the hospital’s review board and the principles of the Declaration of Helsinki, as well as applicable national research regulations.
Informed consent statement: Informed consent was not required for this retrospective study, as it involved the analysis of previously collected clinical data and imaging results.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: The data that support the findings of this study are available from the corresponding author upon reasonable request. Due to privacy and ethical considerations, data are not publicly available.
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: Qun Wang, Department of Radiology, The First People’s Hospital of Jiashan, No. 1218 South Sports Road, Luoxing Street, Jiaxing 314000, Zhejiang Province, China. wangqun330823@163.com
Received: December 13, 2024
Revised: January 23, 2025
Accepted: February 27, 2025
Published online: May 15, 2025
Processing time: 153 Days and 0.5 Hours
Abstract
BACKGROUND

Rectal cancer requires accurate preoperative assessment of T stage and differentiation grade for treatment planning. Traditional imaging and serum markers have limitations in diagnostic accuracy.

AIM

To evaluate the predictive value of dynamic contrast-enhanced-magnetic resonance imaging (DCE-MRI) parameters and serum biomarkers [carbohydrate antigen (CA) 19-9, CA125] for determining T stage and differentiation grade in rectal cancer.

METHODS

We conducted a retrospective review of clinical data from 126 patients who were pathologically diagnosed with rectal cancer between January 2021 to June 2024. Each patient underwent DCE-MRI scans and serum tests for CA19-9 and CA125. Receiver operating characteristic curves were utilized to assess the diagnostic value of DCE-MRI parameters, including volume transfer constant (Ktrans), rate constant (Kep), and volume fraction of extravascular extracellular space (Ve), as well as serum biomarkers for staging and grading rectal cancer. The DeLong test algorithm was employed to evaluate differences in diagnostic performance among the various indicators.

RESULTS

There were statistically higher levels of Ktrans, Ve, CA19-9, and CA125 serum concentrations of patients with advanced T stages and on poorly differentiated tumors than that in patients with low stages and moderate to high differentiation (P < 0.05). Combined use of Ktrans and Ve for T stage diagnosis showed an area under the curve (AUC) of 0.892 [95% confidence interval (CI): 0.832-0.952], which increased to 0.923 (95%CI: 0.865-0.981) when combined with serum biomarkers. For grades differentiation, the combined DCE-MRI parameters had an AUC of 0.883 (95%CI: 0.821-0.945), which rose to 0.912 (95%CI: 0.855-0.969) when combined with serum markers. According to the Delong test, the combined diagnostic method performed better than a single diagnostic method (P < 0.05).

CONCLUSION

The combined application of DCE-MRI functional parameters and serum tumor markers can significantly improve the diagnostic accuracy of T staging and differentiation degree of rectal cancer, providing a new approach to improve the preoperative assessment system of rectal cancer. This combined diagnostic model has important clinical application value, but further validation is needed through large-scale multicenter studies.

Keywords: Rectal cancer; Dynamic contrast-enhanced magnetic resonance imaging; Serum tumor markers; T staging; Differentiation degree; Diagnostic value

Core Tip: This study evaluates the diagnostic efficacy of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) parameters (volume transfer constant, volume fraction of extravascular extracellular space) and serum tumor markers [carbohydrate antigen (CA) 19-9, CA125] in rectal cancer. Results show that combined analysis significantly improves accuracy in assessing T staging and differentiation degree, surpassing individual methods. DCE-MRI captures tumor microenvironment characteristics, while serum markers reflect systemic tumor activity, providing complementary insights. The combined approach achieved area under the curves of 0.923 and 0.912 for T staging and differentiation, respectively, highlighting its clinical utility. These findings suggest that integrating functional imaging with serum biomarkers can enhance preoperative assessment and guide individualized treatment strategies for rectal cancer.