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ORIGINAL RESEARCH article

Front. Oncol.

Sec. Cancer Imaging and Image-directed Interventions

Volume 15 - 2025 | doi: 10.3389/fonc.2025.1457238

Assessment of the imaging quality and heterogeneous predictive value of readout-segmented echo planar imaging for diffusion-weighted rectal MRI

Provisionally accepted
Huiying  WangHuiying Wang1Yichuan  LiangYichuan Liang1Mingrui  SongMingrui Song1Lei  ShiLei Shi2Quanliang  MaoQuanliang Mao1Zhehao  ZhangZhehao Zhang1Aijing  LiAijing Li3*Yuning  PanYuning Pan1*
  • 1Department of Radiology, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang Province, China
  • 2Health Management Center, Shandong Provincial Hospital, Jinan, China
  • 3Department of Radiology, Ningbo Second Hospital, Ningbo, China

The final, formatted version of the article will be published soon.

Objectives: To qualitatively and quantitatively compare the image quality of readout-segmented echo planar imaging (rs-EPI) and single-shot echo planar imaging (ss-EPI) for diffusion-weighted (DWI) rectal MRI, as well as the heterogeneous predictive value of the apparent diffusion coefficient (ADC) values obtained by the two DWI techniques.Methods: The rs-EPI and ss-EPI images were subjectively assessed for lesion sharpness, display of normal structure, overall image quality, geometric distortion, and anatomical differences. The signal-to-noise ratio (SNR), contrast ratio (CR), contrast-to-noise ratio (CNR), and ADC values were objectively compared. Pearson’s correlations and ROC analysis were used to explore the relationships of ADC values obtained by the two techniques and nucleus related antigen (Ki-67) and hypoxia inducible factor-1α (HIF-1α).Results: Eighty patients with rectal cancer (RC) were included. Lesion sharpness, normal structure display, overall image quality, geometric distortion and anatomical structure differences in the rs-EPI DWI group were higher than in the ss-EPI DWI group (P<0.001). SNR, CNR and CR in the rs-EPI DWI group were higher than in the ss-EPI DWI group (P<0.001). ADC values were not different. ROC analysis showed that the area under the curve (AUC) of high Ki-67 and HIF-1α expression levels as predicted by the average ADC of ss-EPI and rs-EPI DWI were 0.82 (95%CI: 0.72-0.92), 0.77 (95%CI: 0.67-0.88), and 0.81 (95%CI: 0.72-0.91), 0.82 (95%CI: 0.72-0.91), respectively, with similar predictive values between the 2 techniques (P=0.23, 0.75).Conclusion: rs-EPI DWI can improve image quality and the ADC value is associated with pathologic markers of tumor aggression.

Keywords: Imaging quality, Readout-segmented echo planar imaging, single-shot echo planar imaging, Diffusion-weighted imaging, Ki-67, hypoxia inducible facor-1α, Predictive Value

Received: 30 Jun 2024; Accepted: 07 Jul 2025.

Copyright: © 2025 Wang, Liang, Song, Shi, Mao, Zhang, Li and Pan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Aijing Li, Department of Radiology, Ningbo Second Hospital, Ningbo, China
Yuning Pan, Department of Radiology, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang Province, China

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