Journal of Medical Systems

, 43:331 | Cite as

Prediction of Clinical Pathologic Prognostic Factors for Rectal Adenocarcinoma: Volumetric Texture Analysis Based on Apparent Diffusion Coefficient Maps

  • Zhihua LuEmail author
  • Lei Wang
  • Kaijian Xia
  • Heng Jiang
  • Xiaoyan Weng
  • Jianlong Jiang
  • Mei Wu
Image & Signal Processing
Part of the following topical collections:
  1. Distributed Analytics and Deep Learning in Health Care


Texture analysis has been used to characterize and measure tissue heterogeneity in medical images. The purpose of this study was to investigate the potential of texture features derived from apparent diffusion coefficient (ADC) maps, to serve as imaging markers for predicting important histopathologic prognostic factors in rectal cancer. One hundred patients of rectal cancer received 3 T preoperative magnetic resonance imaging including diffusion-weighted imaging (DWI). Skewness, kurtosis, uniformity from the histogram and entropy, energy, inertia, correlation from gray-level co-occurrence matrix (GLCM) derived from whole-lesion volumes were measured. Independent sample t-test or Mann-Whitney U-test and receiver operating characteristic (ROC) curves were used for statistical analysis. Uniformity, energy and entropy were significantly different (p = 0.026, 0.001, and 0.006, respectively) between stage pT1–2 and pT3–4 tumors. Skewness, kurtosis and correlation were significantly different (p = 0.000, 0.006, and 0.041, respectively) between grade 1–2 and grade 3 tumors. Energy and entropy (p = 0.008 and 0.033, respectively) could significantly differentiate negative circumferential resection margin (CRM) from positive CRM. Furthermore, predicted probabilities derived by logistic regression analysis yielded greater area under the curve (AUC) in differentiating pT3–4 stage and grade 3 grade tumors. Texture features derived from ADC maps may useful to predict important histopathologic prognostic factors of rectal cancer.


Diffusion-weighted imaging Apparent diffusion coefficient Rectal cancer Texture analysis 



This study was funded by Jiangsu Provincial Medical Youth Talent (QNRC2016212), Suzhou Clinical Special Disease Diagnosis and Treatment Program (LCZX201823), Suzhou GuSu Medical Talent Project (GSWS2019077) and Science and Technology Bureau of Changshu (CS201624).

Compliance with Ethical Standards

Conflict of Interest

Author Zhihua Lu has received research grants from Jiangsu Provincial Medical Youth Talent, Suzhou Clinical Special Disease Diagnosis and Treatment Program, Suzhou GuSu Medical Talent Project and Science and Technology Bureau of Changshu. Author Jianlong Jiang has received research grant from Suzhou Clinical Special Disease Diagnosis and Treatment Program. All authors have no relevant conflicts of interest including specific financial interests relevant to the subject of our manuscript.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Institutional Review Board of Changshu Hospital Affiliated to Soochow University. Requirements for written informed consent were waived due to the retrospective nature of the study.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Zhihua Lu
    • 1
    Email author
  • Lei Wang
    • 1
  • Kaijian Xia
    • 1
  • Heng Jiang
    • 1
  • Xiaoyan Weng
    • 1
  • Jianlong Jiang
    • 1
  • Mei Wu
    • 1
  1. 1.First People’s Hospital of Changshu CityChangshu Hospital Affiliated to Soochow UniversityChangshuChina

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