Diffusion-Weighted MRI As Non-Invasive Diagnostic Tool for Rectal Cancer Aggressiveness and Correlation with KI-67 Expression in Tumor Tissue

Overview

Journal Asian Pac J Cancer Prev

Specialty Oncology

Date 2022 Oct 29

PMID 36308363

Authors

Fadila Mamdouh El Sayed

Eman Mostafa Nassef

Neamat Abdelmageed Abdelmageed

Rania Rifat Abdel Maqsoud

Amany Ibrahim Abosaif

Affiliations

Soon will be listed here.

Abstract

Background And Aim: Apparent diffusion coefficient (ADC) was suggested as a prognostic marker in rectal carcinoma (RC). However, reported data are inconsistent. The present study aimed to assess the relation between ADC value and Ki-67 expression index and other pathological parameters in Egyptian RC patients.

Materials And Methods: The study included 39 patients with newly diagnosed RC (non-mucinous adenocarcinoma). All patients underwent magnetic resonance imaging (MRI) scan by 1.5T magnet. Mean ADC value was calculated. Pathological features were assessed and Ki- 67 immunohistochemical expression was applied as a proliferative index (PI) biomarker.

Results: It was shown that patients with T4 tumors had significantly lower ADC values when compared with patients with T2 and T3 (0.903 ± 0.24 versus 1.157 ± 0.31 and 0.971 ± 0.26 respectively, p<0.001). Also, patients with circumferential resection margin (CRM) involvement had significantly lower ADC values when compared with patients without (0.905 ± 0.24 versus 1.109 ± 0.30, p=0.036). Patients with T4 tumors expressed significantly higher ki-67 PI when compared with patients with T2 and T3 tumors (75.71 ± 5.14 versus 46.25 ± 5.18 and 75.71 ± 5.14 respectively, p<0.001). Pearson's correlation coefficient identified a significant inverse correlation between ADC values and ki-67 PI (r=-367, p=0.027).

Conclusion: ADC values of RC may reflect tumor staging and Ki-67 is closely related to the ADC value confirm this result.

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References

Sevcenco S, Haitel A, Ponhold L, Susani M, Fajkovic H, Shariat S . Quantitative apparent diffusion coefficient measurements obtained by 3-Tesla MRI are correlated with biomarkers of bladder cancer proliferative activity. PLoS One. 2014; 9(9):e106866. PMC: 4159261. DOI: 10.1371/journal.pone.0106866. View

Li W, Zhang G, Wang H, Wang L . Analysis of expression of cyclin E, p27kip1 and Ki67 protein in colorectal cancer tissues and its value for diagnosis, treatment and prognosis of disease. Eur Rev Med Pharmacol Sci. 2016; 20(23):4874-4879. View

Padhani A, Liu G, Koh D, Chenevert T, Thoeny H, Takahara T . Diffusion-weighted magnetic resonance imaging as a cancer biomarker: consensus and recommendations. Neoplasia. 2009; 11(2):102-25. PMC: 2631136. DOI: 10.1593/neo.81328. View

Sun Y, Tong T, Cai S, Bi R, Xin C, Gu Y . Apparent Diffusion Coefficient (ADC) value: a potential imaging biomarker that reflects the biological features of rectal cancer. PLoS One. 2014; 9(10):e109371. PMC: 4193754. DOI: 10.1371/journal.pone.0109371. View

Islami F, Ward E, Sung H, Cronin K, Tangka F, Sherman R . Annual Report to the Nation on the Status of Cancer, Part 1: National Cancer Statistics. J Natl Cancer Inst. 2021; 113(12):1648-1669. PMC: 8634503. DOI: 10.1093/jnci/djab131. View

Schurink N, Lambregts D, Beets-Tan R . Diffusion-weighted imaging in rectal cancer: current applications and future perspectives. Br J Radiol. 2018; 92(1096):20180655. PMC: 6540856. DOI: 10.1259/bjr.20180655. View

Ao W, Bao X, Mao G, Yang G, Wang J, Hu J . Value of Apparent Diffusion Coefficient for Assessing Preoperative T Staging of Low Rectal Cancer and Whether This Is Correlated With Ki-67 Expression. Can Assoc Radiol J. 2020; 71(1):5-11. DOI: 10.1177/0846537119885666. View

Akashi M, Nakahusa Y, Yakabe T, Egashira Y, Koga Y, Sumi K . Assessment of aggressiveness of rectal cancer using 3-T MRI: correlation between the apparent diffusion coefficient as a potential imaging biomarker and histologic prognostic factors. Acta Radiol. 2013; 55(5):524-31. DOI: 10.1177/0284185113503154. View

Amin M, Greene F, Edge S, Compton C, Gershenwald J, Brookland R . The Eighth Edition AJCC Cancer Staging Manual: Continuing to build a bridge from a population-based to a more "personalized" approach to cancer staging. CA Cancer J Clin. 2017; 67(2):93-99. DOI: 10.3322/caac.21388. View

10.

Kobayashi S, Koga F, Kajino K, Yoshita S, Ishii C, Tanaka H . Apparent diffusion coefficient value reflects invasive and proliferative potential of bladder cancer. J Magn Reson Imaging. 2013; 39(1):172-8. DOI: 10.1002/jmri.24148. View

11.

Gurses B, Boge M, Altinmakas E, Balik E . Multiparametric MRI in rectal cancer. Diagn Interv Radiol. 2019; 25(3):175-182. PMC: 6521905. DOI: 10.5152/dir.2019.18189. View

12.

Melling N, Kowitz C, Simon R, Bokemeyer C, Terracciano L, Sauter G . High Ki67 expression is an independent good prognostic marker in colorectal cancer. J Clin Pathol. 2015; 69(3):209-14. DOI: 10.1136/jclinpath-2015-202985. View

13.

Ahmed N, Ismail A, Kareem T . A clinicopathologic study of Ki-67 proliferation index in colorectal carcinoma. Saudi Med J. 2012; 33(8):841-5. View

14.

Tong G, Zhang G, Liu J, Zheng Z, Chen Y, Niu P . Cutoff of 25% for Ki67 expression is a good classification tool for prognosis in colorectal cancer in the AJCC‑8 stratification. Oncol Rep. 2020; 43(4):1187-1198. PMC: 7058009. DOI: 10.3892/or.2020.7511. View

15.

Meng X, Li H, Kong L, Zhao X, Huang Z, Zhao H . MRI In rectal cancer: Correlations between MRI features and molecular markers Ki-67, HIF-1α, and VEGF. J Magn Reson Imaging. 2016; 44(3):594-600. DOI: 10.1002/jmri.25195. View

16.

Luo Z, Zhu M, Zhang Z, Ye F, Huang W, Luo X . Increased expression of Ki-67 is a poor prognostic marker for colorectal cancer patients: a meta analysis. BMC Cancer. 2019; 19(1):123. PMC: 6364416. DOI: 10.1186/s12885-019-5324-y. View

17.

Curvo-Semedo L, Lambregts D, Maas M, Beets G, Caseiro-Alves F, Beets-Tan R . Diffusion-weighted MRI in rectal cancer: apparent diffusion coefficient as a potential noninvasive marker of tumor aggressiveness. J Magn Reson Imaging. 2012; 35(6):1365-71. DOI: 10.1002/jmri.23589. View

18.

Horvat N, Rocha C, Oliveira B, Petkovska I, Gollub M . MRI of Rectal Cancer: Tumor Staging, Imaging Techniques, and Management. Radiographics. 2019; 39(2):367-387. PMC: 6438362. DOI: 10.1148/rg.2019180114. View

19.

Choi M, Huh J, Shin J, Park Y, Cho Y, Kim H . Prognostic Factors and Treatment of Recurrence after Local Excision of Rectal Cancer. Yonsei Med J. 2021; 62(12):1107-1116. PMC: 8612863. DOI: 10.3349/ymj.2021.62.12.1107. View

20.

Aladhraei M, Kassem Al-Thobhani A, Poungvarin N, Suwannalert P . Association of XPO1 Overexpression with NF-κB and Ki67 in Colorectal Cancer. Asian Pac J Cancer Prev. 2019; 20(12):3747-3754. PMC: 7173379. DOI: 10.31557/APJCP.2019.20.12.3747. View