ArticleQuantitative imaging in medicine and surgery2026
The role of transrectal doppler ultrasound in the evaluation of rectal lesions: a large-sample analysis of 400+ cases.
Article in Quantitative imaging in medicine and surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Color Doppler ultrasonography technology has demonstrated excellent diagnostic performance across diverse clinical scenarios; however, research on its use in rectal tumor evaluation remains underexplored. This study aimed to evaluate the diagnostic value of transrectal ultrasound (TRUS)-derived vascular features in differentiating between malignant and benign rectal lesions, preoperative tumor staging, and monitoring the neoadjuvant therapy (NT) response. Methods: A retrospective cohort of 452 patients with TRUS-detected gastrointestinal lesions was analyzed. Vascular parameters, including peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistive index (RI), were recorded. Histopathological findings served as the diagnostic gold standard. Results: Of the 452 cases, 428 (94.7%) were pathologically confirmed as malignant, while 24 (5.3%) were benign. The malignant group exhibited significantly higher PSV and RI values than the benign group (P<0.05). An RI threshold of >0.67 for malignancy detection resulted in a sensitivity of 78% and a specificity of 80%. Grade 3 (G3) tumors had higher PSV than grade 2 (G2) tumors, and G2 tumors had higher PSV than grade 1 (G1) tumors. Among the three tumor grades (P<0.05), the G3 tumors had the highest RI value (0.77), while the G1 tumors had the lowest RI value (0.68). In the pathology nodal stage (pN-stage) cases, pN2-stage cases exhibited a significantly higher PSV (20.1 cm/s) compared to both the pN0 (16.7 cm/s) and pN1 (15.9 cm/s) cases (P<0.001). In pathology tumor stage (pT-stage) cases, only pT4-stage cases showed higher RI than pT1-stage cases. After NT, the PSV and RI values decreased significantly (18.3 Conclusions: TRUS vascular parameters, particularly PSV and RI, demonstrate strong diagnostic value in differentiating between malignant and benign rectal lesions, and differ significantly across some tumor differentiation grades and pN-/pT-stages. Additionally, these parameters can serve as effective biomarkers for monitoring NT efficacy.
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