Assessing pathological prognostic factors of resectable rectal cancer: comparison of a monoexponential model and multiple advanced DWI models

Motivation: Diffusion-weighted imaging (DWI) can help to predicti rectal cancer prognosis; however, inconsistencies in its effectiveness necessitate exploring advanced DWI models to improve diagnostic accuracy. Goal(s): We investigated the value of the stretched exponential (SEM), fractional-order calculus (FROC), and continuous-time random-walk (CTRW) models in assessing prognostic factors for rectal cancer. Approach: This study included 181 rectal cancer patients with using traditional and advanced DWI models to explore correlations between DWI parameters and histopathological indicators. Results: The parameters of advanced DWI models were significantly correlated with histopathological prognostic factors. CTRW-α was the superior predictor for histological type and pT stage. Impact: Our study demonstrates the value of CTRW model in predicting prognostic factors for rectal cancer. Utilizing these noninvasive and accurate advanced DWI models before surgery can help physicians to make appropriate surgical plan to help patients achieve better prognosis.