{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T06:16:53Z","timestamp":1771481813442,"version":"3.50.1"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,10,2]],"date-time":"2024-10-02T00:00:00Z","timestamp":1727827200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>The apparent diffusion coefficient (ADC) is a quantitative parameter that facilitates the detection and reliable differentiation of rectal cancer. MR differentiation between rectal carcinoma, post-radiation proctitis, and normal rectal wall with the ADC values and their comparison depending on\u00a0the level of tumor markers and pathohistological characteristics of rectal carcinoma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The retrospective study performed at the Oncology Institute of Vojvodina included 300 patients, 100 each with rectal cancer, post-radiation proctitis, and normal rectum. Mean ADC values were obtained by measuring the region of interest (ROI) of the rectal wall.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Rectal cancer showed lower ADC values (0.665 \u00b1 0.086 x 10<jats:sup>-3<\/jats:sup>mm<jats:sup>2<\/jats:sup>\/s) compared to both post-radiation proctitis (1.648 \u00b1 0.268 x 10<jats:sup>-3<\/jats:sup>mm<jats:sup>2<\/jats:sup>\/s) and normal rectum (1.180 \u00b1 0.110 x 10<jats:sup>-3<\/jats:sup>mm<jats:sup>2<\/jats:sup>\/s) (p&amp;lt;0.001). No significant differences in ADC values were observed between different grades of rectal cancer (p=0.874; p&amp;gt;0.05), depending on the presence of metastases in the lymph nodes (p=0.357; p&amp;gt;0.05), different TN stage (p=0.196; p&amp;gt;0.05), local spread of the tumor (p=0.312; p&amp;gt;0.05), the presence of RAS mutation (p=0.829; p&amp;gt;0.05) and the value of tumor markers (p=0.923; p&amp;gt;0.05). ADC values below 1.013 x 10<jats:sup>-3<\/jats:sup>mm<jats:sup>2<\/jats:sup>\/s with 100% sensitivity and 96% specificity indicate the presence of rectal cancer in relation to normal wall, with a positive predictive value of 96.1% and a negative of 100%. ADC values below 1.255 x 10<jats:sup>-3<\/jats:sup>mm<jats:sup>2<\/jats:sup>\/s with 100% sensitivity and 95% specificity indicate rectal cancer in relation to post-radiation proctitis. ADC values above 1.339 x 10<jats:sup>-3<\/jats:sup>mm<jats:sup>2<\/jats:sup>\/s with 87% sensitivity and 89% specificity indicate post-radiation proctitis in relation to normal wall.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>The ADC is a useful marker in differentiating between rectal cancer, post-radiation proctitis, and normal rectal wall with high sensitivity and specificity, but it cannot be used to distinguish the histological grades of rectal cancer, nor other pathohistological parameters.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fonc.2024.1464183","type":"journal-article","created":{"date-parts":[[2024,10,2]],"date-time":"2024-10-02T04:10:29Z","timestamp":1727842229000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Significance of apparent diffusion coefficient in diagnosis of rectal 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