Predictive value of combined DCE-MRI perfusion parameters and clinical features nomogram for microsatellite instability in colorectal cancer

Motivation: The identification of microsatellite instability (MSI) aids in stratified treatment for colorectal cancer (CRC) patients. MSI detection relies on postoperative pathological immunohistochemistry or polymerase chain reaction (PCR), often limited to high-level medical institutions. Therefore, developing a non-invasive, personalized technique for preoperative MSI prediction is essential. Goal(s): A nomogram integrating DCE-MRI parameters, ADC values, and clinical features demonstrates excellent predictive performance for MSI in CRC. Approach: A nomogram was constructed using DCE-MRI parameters (Ktrans, Kep, and iAUC), ADC values, and clinical features to assess the MSI of CRC patients. Results: The nomogram model shows great potential for preoperative individualized identification of MSI in CRC. Impact: MSI CRC is resistant to 5-FU chemotherapy but benefits from neoadjuvant immunotherapy and targeted therapy. The nomogram model provides a good non-invasive and individualized tool for predicting MSI, avoiding the risks associated with invasive pathological detection.