The aim of this study was to evaluate the feasibility of quantitative synthetic magnetic resonance imaging (SyMRI)-derived histogram of the primary tumor for predicting the regional lymph node (LN) metastasis in patients with rectal cancer (RC). Our study indicated that histogram parameters of primary tumor on T1 mapping and T2 mapping were associated with regional LN status in RC. Moreover, the combination of the quantitative SyMRI parameters, pathological extramural venous invasion (EMVI), and maximum tumor diameter may significantly improve the predictive performance of LN metastasis.
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