T1 Mapping-Derived Extracellular Volume Fraction for Non-Invasive Assessment of Tumor-Stroma Ratio in Rectal Cancer.

Authors

Jie Yuan, Yiqun Sun, Hao Zhou, Yu Cao, Mengxiao Liu, Kun Liu, Mingrong Yao, Wenli Tan

Published in

Abdominal radiology (New York). Sep 06, 2026. Epub Sep 06, 2026.

Abstract

To investigate the value of extracellular volume fraction (ECV) derived from T1 mapping and apparent diffusion coefficient (ADC) for non-invasive assessment of tumor stroma percentage (TSP) in rectal cancer.
This prospective study enrolled 158 patients (104 men, 54 women; mean age 65.96 ± 10.87 years) with rectal adenocarcinoma. All patients underwent 3.0T MRI including pre- and post-contrast T1 mapping and diffusion-weighted imaging. ECV was calculated from native and post-contrast T1 values. TSP was histopathologically assessed on surgical specimens. Interobserver reproducibility, correlations with TSP, diagnostic performance for stroma-rich tumors (TSP > 50%), and associations with clinicopathological features were evaluated.
The pre- and post-contrast T1 measurements used to calculate ECV showed excellent interobserver reproducibility (ICC = 0.978 and 0.964, respectively). ECV showed a moderate positive correlation with TSP (ρ = 0.520, P < 0.001), whereas ADC showed no significant correlation (ρ = 0.070, P > 0.05). ECV demonstrated good discrimination of stroma-rich tumors (AUC, 0.819; 95% CI 0.742-0.897), whereas ADC derived from the two-b-value DWI protocol did not discriminate between stroma-rich and stroma-poor tumors (AUC, 0.495; 95% CI: 0.398-0.592; P < 0.001 vs. ECV). Adding ADC to ECV did not significantly improve diagnostic performance compared with ECV alone (AUC = 0.845, P > 0.05; DeLong P > 0.05). ECV differed across tumor differentiation grades after correction (P < 0.05), but not according to LVI status (P > 0.05).
T1 mapping-derived ECV was reproducible and showed a moderate association with histological TSP, with good performance for distinguishing stroma-rich from stroma-poor tumors.

PMID:
42701972
Bibliographic data and abstract were imported from PubMed on 07 Sep 2026.

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