ArticleAbdominal radiology (New York)2026
T1 Mapping-Derived Extracellular Volume Fraction for Non-Invasive Assessment of Tumor-Stroma Ratio in Rectal Cancer.
Article in Abdominal radiology (New York), 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
purposeTo investigate the value of extracellular volume fraction (ECV) derived from T1 mapping and apparent diffusion coefficient (ADC) for non-invasive assessment of tumor stroma percentage (TSP) in rectal cancer.
methodsThis prospective study enrolled 158 patients (104 men, 54 women; mean age 65.96 ± 10.87 years) with rectal adenocarcinoma. All patients underwent 3.0T MRI including pre- and post-contrast T1 mapping and diffusion-weighted imaging. ECV was calculated from native and post-contrast T1 values. TSP was histopathologically assessed on surgical specimens. Interobserver reproducibility, correlations with TSP, diagnostic performance for stroma-rich tumors (TSP > 50%), and associations with clinicopathological features were evaluated.
resultsThe pre- and post-contrast T1 measurements used to calculate ECV showed excellent interobserver reproducibility (ICC = 0.978 and 0.964, respectively). ECV showed a moderate positive correlation with TSP (ρ = 0.520, P < 0.001), whereas ADC showed no significant correlation (ρ = 0.070, P > 0.05). ECV demonstrated good discrimination of stroma-rich tumors (AUC, 0.819; 95% CI 0.742-0.897), whereas ADC derived from the two-b-value DWI protocol did not discriminate between stroma-rich and stroma-poor tumors (AUC, 0.495; 95% CI: 0.398-0.592; P < 0.001 vs. ECV). Adding ADC to ECV did not significantly improve diagnostic performance compared with ECV alone (AUC = 0.845, P > 0.05; DeLong P > 0.05). ECV differed across tumor differentiation grades after correction (P < 0.05), but not according to LVI status (P > 0.05).
conclusionT1 mapping-derived ECV was reproducible and showed a moderate association with histological TSP, with good performance for distinguishing stroma-rich from stroma-poor tumors.
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