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. 2025 Aug 9.
doi: 10.1007/s00261-025-05126-0. Online ahead of print.

MRI for prognosis prediction of T3-stage rectal cancer based on "DISTANCE" structural report

Yuen Xie  1 , Jiaqi Chen  1 , Rui Song  1 , Yehuan Tang  1 , Peiyin Chen  1 , Chongze Yang  1 , Chengdi Deng  1 , Hui Li  1 , Jinyuan Liao  1 , Liling Long  2   3
Affiliations

MRI for prognosis prediction of T3-stage rectal cancer based on "DISTANCE" structural report

Yuen Xie et al. Abdom Radiol (NY). .

Abstract

Purpose: To explore whether magnetic resonance imaging (MRI) features, when employed with the MRI structural report "DISTANCE," allow the prediction of the overall survival (OS) and progression-free survival (PFS) of patients with T3-stage rectal cancer and to provide information for improved preoperative diagnosis and prognosis evaluation of T3-stage rectal cancer.

Methods: This is a retrospective analysis of 205 cases of T3-stage rectal cancer from January 2014 to January 2021. Univariate, multivariate, and LASSO Cox regression analyses were performed to identify prognostic factors, construct OS and PFS feature nomograms, evaluate the value of MRI features in predicting OS and PFS, and visualize their impact on OS and PFS using Kaplan-Meier survival curves.

Results: The circumferential resection margin (CRM), obturator lymph node (Obturator N), extramural depth (EMD), maximum short axis of lymph node (maximum short axis of N), and mrEMVI were identified as independent predictors of OS and PFS. The nomogram model predicted the AUCs of OS at 2, 3, and 5 years as 0.806, 0.775, and 0.815, respectively, and those for PFS as 0.695, 0.729, and 0.726 at 2, 3, and 5 years, respectively.

Conclusion: The CRM, EMD, Obturator N, maximum short axis of N, and mrEMVI from the MRI structural report "DISTANCE" should be employed for the prognosis prediction of T3-stage rectal cancer.

Keywords: Magnetic resonance imaging; Rectal cancer; Structured report; Survival analysis; T3 stage.

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Conflict of interest statement

Declarations. Conflict of interest: The authors declare no conflict of interest.

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