The aim of this study was to evaluate the influence of different segmentation strategies on diffusion parameters and the performance of diffusion kurtosis imaging in predicting rectal cancer histopathological characteristics before a treatment decision is made. The results show that the whole-tumor-volume segmentation strategy could achieve the best inter- and intra-observer repeatability among the six different strategies, and DKI with this segmentation strategy performed accurately for differentiating between well-differentiated and poorly to moderately differentiated patients.
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