Prediction of lymph node metastasis in rectal cancer: comparison between shear-wave elastography based ultrasomics and MRI.

purposeWe aimed to explore the diagnostic efficiency of shear-wave elastography (SWE) ultrasomics in the preoperative prediction of lymph node (LN) metastasis in rectal cancer.

methodsThis study included 87 patients with pathologically confirmed rectal cancer, with data gathered from August 2017 to August 2018. A total of 1044 ultrasomics features of rectal tumor were collected with AK software from the SWE examinations. The least absolute shrinkage and selection operator (LASSO) regression model was used for feature selection and building a SWE ultrasomics signature. The diagnostic performance was evaluated with an area under the receiver operating characteristic curve (AUC) analysis. Then, the diagnostic performance of the SWE ultrasomics signature was compared with magnetic resonance imaging (MRI).

resultsOf the 87 patients, 40 (46.0%) had LN metastasis. Thirteen ultrasomics features of rectal tumor were selected as the most significant features. The SWE ultrasomics signature correlated with LN metastasis (p < 0.001). Patients with LN metastasis had higher signature than patients without LN metastasis. In terms of diagnostic performance, SWE ultrasomics signature was significantly superior to MRI (AUC, 0.883 vs. 0.760, p = 0.034). The diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of SWE ultrasomics signature were 82.8%, 87.5%, 78.8%, 77.8%, and 88.1%, respectively, while those of MRI were 75.9%, 77.5%, 74.5%, 72.1%, and 79.6%, respectively.

conclusionSWE ultrasomics is a more accurate predictive method for identifying LN metastasis preoperatively than MRI. Thus, SWE ultrasomics might be used to better guide preoperative individual therapies for patients with rectal cancer.