ArticleInsights into imaging2026
Performance of dual-layer spectral CT-based extracellular volume fraction to assess Ki-67 proliferation status in rectal cancer: comparison with diffusion kurtosis imaging.
Article in Insights into imaging, 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
objectiveTo evaluate and compare MRI-based diffusion kurtosis imaging (DKI), diffusion-weighted imaging (DWI), and dual-layer spectral CT (DLSCT)-derived extracellular volume (ECV) fraction for predicting the Ki-67 proliferation index in rectal cancer (RC). MATERIALS AND
methodsThis retrospective study included 117 patients with pathologically confirmed rectal adenocarcinoma who underwent preoperative MRI and DLSCT. Patients were divided into high (Ki-67 > 50%) and low (Ki-67 ≤ 50%) Ki-67 groups based on postoperative immunohistochemistry. Parameters from DKI (mean diffusivity (D
resultsThe high Ki-67 group exhibited significantly higher K
conclusionDLSCT-derived ECV fraction demonstrated superior performance to diffusion-based MRI parameters for predicting the proliferation status of RC, providing a more comprehensive assessment of the tumor microenvironment. KEY POINTS: Question Noninvasive preoperative biomarkers are lacking to assess Ki-67 proliferation status and guide personalized treatment strategies for patients with rectal cancer. Findings Dual-layer spectral CT (DLSCT)-derived extracellular volume (ECV) fraction outperformed MRI diffusion parameters for Ki‑67 and correlated with T/N stage, differentiation, and extramural vascular invasion. Critical relevance statement This study validates Dual-layer spectral CT (DLSCT)-derived extracellular volume (ECV) fraction as a non‑invasive biomarker that outperforms MRI diffusion parameters for Ki‑67 assessment and correlates with tumor aggressiveness, advancing personalized treatment decision‑making in rectal cancer radiology.
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