Texture Analysis Based on Sagittal Fat-Suppression and Transverse T2-Weighted Magnetic Resonance Imaging for Determining Local Invasion of Rectal Cancer

Background: Accurate evaluation of local invasion (T-stage) of rectal cancer is essential for treatment planning. A search of PubMed database indicated that the correlation between texture features from T2-weighted magnetic resonance imaging (T2WI) (MRI) and T-stage has not been explored extensively. Purpose: To evaluate the performance of texture analysis using sagittal fat-suppression combined with transverse T2WI for determining T-stage of rectal cancer. Methods: One hundred and seventy-four rectal cancer cases who underwent preoperative MRI were retrospectively selected and divided into high (T3/4) and low (T1/2) T-stage groups. Texture features were, respectively, extracted from sagittal fat-suppression and transverse T2WI images. Univariate and multivariate analyses were conducted to determine T-stage. Discrimination performance was assessed by receiver operating characteristic (ROC) analysis. Results: For univariate analysis, the best performance in differentiating T1/2 from T3/4 tumors was achieved from transverse T2WI, and the area under the ROC curve (AUC) was 0.740. For multivariate analysis, the logical regression model incorporating the independent predictors achieved an AUC of 0.789. Conclusions: Texture features from sagittal fat-suppression combined with transverse T2WI presented moderate association with T-stage of rectal cancer. These findings may be valuable in selecting optimum treatment strategy.