Glucose Chemical Exchange Saturation Transfer MRI for Predicting the Histological Grade of Rectal Cancer

Motivation: The histological grade of rectal cancer has a considerable involvement in treatment strategies and prognosis in relevant patients. Goal(s): To evaluate the utility of glucose chemical exchange saturation transfer (glucoCEST) MRI with non-contrast injection in predicting the histological grade of rectal cancer. Approach: This prospective analysis included 60 patients with rectal cancer who underwent pelvic glucoCEST, APTWI, and DWI. Results: Elevated MTRasym (1.2 ppm), MTRasym (3.5 ppm) values and lower ADC values were observed in the high-grade group compared with low-grade cases (all P < 0.01). The AUCs of MTRasym (1.2 ppm), MTRasym (3.5 ppm), and ADC were 0.792, 0.839, and 0.855, respectively. Impact: These preliminary data demonstrate that glucoCEST MRI without contrast injection has the potential to provide a non-invasive assessment of histological grade in rectal cancer and add value to current tools used for the differentiation between high- and low-grade rectal cancer.