Application of diffusion kurtosis imaging for differentiating T0-T1 from T2 rectal tumors

Motivation: Accurate MRI-based staging of early rectal tumors is crucial for decision-making in an era of organ-sparing treatment strategies. Goal(s): To investigate the value of DKI for distinguishing between T0-T1 and T2 rectal tumors. Approach: 138 patients with pathologically proven T0-T2 rectal tumors were evaluated with HR-T2WI, kurtosis and diffusivity from DKI, and ADC from DWI. Results: Diffusivity in pT0-T1 rectal tumors was significantly higher compared to pT2 rectal tumors and exhibited the highest diagnostic value in determining pT0-T1 rectal tumors, with an AUC of 0.810, a sensitivity of 70.0%, and a specificity of 82.7%. Impact: Diffusivity obtained from DKI has the potential to serve as a biomarker for early rectal tumor assessment, providing valuable information for selecting appropriate patients for organ preservation surgery.