Whole-volume Apparent Diffusion Coefficient-based Entropy Parameters for Assessment of Gastric Cancer Aggressiveness

Purpose: To explore the role of whole-volume apparent diffusion coefficient (ADC)-based entropy parameters in the preoperative assessment of gastric cancer's aggressiveness.

Materials And Methods: In all, 64 patients with gastric cancers who underwent 3.0T magnetic resonance imaging (MRI) were retrospectively included. Regions of interest were drawn manually using in-house software, around gastric cancer lesions on each slice of the diffusion-weighted images and ADC maps. Entropy-related parameters based on ADC maps were calculated automatically: (1) first-order entropy; (2-5) second-order entropies, including entropy(H) , entropy(H) , entropy(H) , and entropy(H) ; (6) entropy(H) ; and (7) entropy(H) . Correlations between entropy-related parameters and pathological characteristics were analyzed with the Spearman correlation test. The parameters were compared among different pathological characteristics with independent-samples Kruskal-Wallis or Mann-Whitney U-test. Additionally, diagnostic performances of parameters in differentiating different pathological characteristics were analyzed by receiver operating characteristic (ROC) curve analysis.

Results: All the entropy-related parameters significantly correlated with T, N, and overall stages, especially the first-order entropy (r = 0.588, 0.585, and 0.677, respectively, all P < 0.05). All the entropy-related parameters showed significant differences in gastric cancers at different T, N, and overall stages, as well as at different status of vascular invasion (P < 0.001-0.027). And four parameters, including entropy, entropy(H) , entropy(H) , and entropy(H) , showed significant differences between gastric cancers with and without perineural invasion (P 0.006-0.040).

Conclusion: Entropy-related parameters derived from whole-volume ADC texture analysis could help assess the aggressiveness of gastric cancers via analyzing intratumoral heterogeneity quantitatively, especially the first-order entropy.

Level Of Evidence: 2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;47:168-175.