Association between high-resolution MRI-detected extramural vascular invasion and tumour microcirculation estimated by dynamic contrast-enhanced MRI in rectal cancer: preliminary results

BACKGROUND: To determine whether magnetic resonance imaging (MRI)-detected extramural vascular invasion (mrEMVI) status is associated with quantitative perfusion parameters derived from dynamic contrast-enhanced MRI (DCE-MRI) in rectal cancer. METHODS: Seventy-two patients with rectal adenocarcinoma who underwent curative surgery alone within 2 weeks following rectal MRI were enrolled in this retrospective study. mrEMVI status was determined based on high-resolution MRI. The quantitative perfusion parameters (K(trans), k(ep) and v(e)) derived from DCE-MRI were calculated from all sections containing tumours. DCE-MRI parameters and clinicopathological variables in patients with different mrEMVI statuses were compared. RESULTS: For patients who were mrEMVI positive, the tumours demonstrated significantly lower k(ep) values (P = 0.012) and higher v(e) values (P = 0.021) than tumours of patients who were mrEMVI negative, while the K(trans) value displayed no significant difference (P = 0.390). The patients who were mrEMVI positive had larger tumour size, higher pathological tumour stage and increased regional nodal metastases compared to those who were mrEMVI negative (2.9 cm vs. 3.5 cm, P = 0.011; 63.8% vs. 92.0%, P = 0.010; 36.2% vs. 76.0%, P = 0.001; respectively). CONCLUSIONS: This study demonstrated for the first time that tumour microcirculation is altered in mrEMVI-positive patients with rectal adenocarcinoma, as evidenced by significantly lower k(ep) and higher v(e) values. In addition, these patients were more likely to have a larger tumour size, a higher pathological tumour stage and regional nodal metastases than mrEMVI-negative patients.