Purpose. To explore the role of histogram analysis of perfusion parameters from dynamic contrast-enhanced magnetic resonance\nimaging (DCE-MRI) based on entire tumor volume in discriminating tumor characteristics and predicting therapeutic response\nin rectal cancer. Materials and Methods. Thirty-seven DCE-MRIs of locally advanced rectal cancer patients who received\nchemoradiation therapy (CRT) before surgery were analyzed by pharmacokinetic model for quantification and histogram analysis\nof perfusion parameters.The results were correlated with tumor characteristics including EGFR expression, KRAS mutation, and\nCRT response based on the pathologic tumor regression grade (TRG). Results.Thearea under the contrast agent concentration-time\ncurve (AUC) skewness was significantly lower in patients with node metastasis. The vp histogram parameters were significantly\nhigher in group with perineural invasion (PNI). The receiver operating characteristics (ROC) curve analyses showed that mode\nvp revealed the best diagnostic performance of PNI. The values of Ktrans and kep were significantly higher in the group with\nKRAS mutation. ROC curve analyses showed thatmean and mode Ktrans demonstrated excellent diagnostic performance of KRAS\nmutation.DCE-MRI parameters did not demonstrate statistical significance in correlatingwith TRG. Conclusion. These preliminary\nresults suggest that a larger proportion of higher AUC skewness was present in LN metastasis group and a higher vp histogram\nvalue was present in rectal cancer with PNI. In addition, Ktrans and kep histogram parameters showed difference according to the\nKRAS mutation, demonstrating the utility of the histogram of perfusion parameters derived from DCE-MRI as potential imaging\nbiomarkers of tumor characteristics and genetic features.
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