Non-invasive prediction of KRAS mutation in rectal cancer using hybrid intravoxel incoherent motion and diffusion kurtosis model

Motivation: KRAS mutation detection in rectal cancer is crucial but currently requires invasive biopsies. Non-invasive imaging biomarkers are needed. Goal(s): Evaluate the efficacy of a hybrid IVIM-DKI model in predicting KRAS mutation status in rectal cancer patients. Approach: 73 patients underwent IVIM-DKI MRI before surgery. IVIM-DKI parameters were compared between KRAS mutant and wild-type groups. Results: Significant differences in ADC, D, and K values between groups. K value showed highest diagnostic accuracy (AUC 0.779) for predicting KRAS mutation status. Impact: The hybrid IVIM-DKI model, especially the K value, demonstrates potential as a non-invasive imaging biomarker for KRAS mutation status in rectal cancer. This approach could guide treatment decisions and evaluate prognosis without invasive biopsies, potentially improving patient care and outcomes in rectal cancer management.