Role of intravoxel incoherent motion MRI in preoperative evaluation of DNA mismatch repair status in rectal cancers

Clin Radiol. 2019 Oct;74(10):814.e21-814.e28. doi: 10.1016/j.crad.2019.07.004. Epub 2019 Aug 16.

Abstract

Aim: To explore the role of intravoxel incoherent motion (IVIM) magnetic resonance imaging (MRI) in evaluating DNA mismatch repair (MMR) status of rectal cancers preoperatively.

Materials and methods: Seventy-six patients with a diagnosis of rectal cancer confirmed at endoscopic biopsy were enrolled prospectively and underwent IVIM MRI before surgery.

Results: The perfusion fraction (f) values of MMR proteins (MMRP) positive rectal cancers were significantly higher than negative cancers. The f values could differentiate MMRP positive rectal cancers from negative cancers with an area under the curve (AUC) of 0.695. The vascular endothelial growth factor (VEGF) and vascular endothelial growth factor receptor 2 (VEGFR2) expression rates of positive MMRP rectal cancers were significantly higher than negative cancers.

Conclusion: This pilot study indicated that the f value derived from IVIM MRI differed significantly between rectal cancers with different MMRP expression levels, which might be involved with different VEGF and VEGFR2 expression rates.

MeSH terms

  • Adenocarcinoma / diagnostic imaging
  • Adenocarcinoma / metabolism
  • Adult
  • Aged
  • Aged, 80 and over
  • DNA Mismatch Repair*
  • DNA-Binding Proteins / metabolism
  • ErbB Receptors / metabolism
  • Female
  • Humans
  • Immunohistochemistry
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Mismatch Repair Endonuclease PMS2 / metabolism
  • MutL Protein Homolog 1 / metabolism
  • MutS Homolog 2 Protein / metabolism
  • Pilot Projects
  • Prospective Studies
  • Rectal Neoplasms / diagnostic imaging*
  • Rectal Neoplasms / metabolism
  • Vascular Endothelial Growth Factor A / metabolism
  • Vascular Endothelial Growth Factor Receptor-2 / metabolism

Substances

  • DNA-Binding Proteins
  • G-T mismatch-binding protein
  • MLH1 protein, human
  • Vascular Endothelial Growth Factor A
  • ErbB Receptors
  • KDR protein, human
  • Vascular Endothelial Growth Factor Receptor-2
  • PMS2 protein, human
  • MSH2 protein, human
  • Mismatch Repair Endonuclease PMS2
  • MutL Protein Homolog 1
  • MutS Homolog 2 Protein