Fig. 1

High Stiffness Leads to Poor Prognosis in Colorectal Cancer. A Representative MRI 3D SPACE T2w images, T1, MRE magnitude images, and c-maps (in colour) for CRC patients, presented in both transverse (TRA) and sagittal (SAG) views. B Line graph depicting shear wave velocity in tumour and adjacent normal tissues from 107 CRC patients. Tumour tissues exhibit significantly higher shear wave velocity than normal tissues (p-values determined using a matched T-test). C Representative MRE images and Masson staining results for High Tumour Stiffness and Low Tumour Stiffness. The upper red region denotes the tumour region of interest (ROI), while the lower panels display Masson staining images with scale bars of 200 μm and 50 μm, respectively. D Spearman correlation analysis between tumour stiffness and collagen ratio in 107 patients. The collagen ratio is quantified from Panel C (R = 0.25, P = 0.009). The grey area represents the 95% confidence interval. E–G Violin plots illustrate the relationships between tumour stiffness and T stage (E), N stage (F), and TNM stage (G). Elevated stages in all categories correlate with increased tumour stiffness. Statistical significance was determined using a two-tailed Student's t-test (N = 107 for all plots). H. Receiver Operating Characteristic (ROC) curve analysis was performed for collagen content, tumour stiffness, c-tumour, and c-tumour adjacent parameters based on patient death data. The Area Under the Curve (AUC) for tumour stiffness was 0.694, with the best cutoff value of 1.74. I-J. Kaplan–Meier plots comparing patients' overall survival (OS) based on tumour stiffness and collagen content. Patients with high stiffness and high collagen exhibit poorer survival rates than those with low stiffness and low collagen (evaluated using the log-rank test). For all panels: *p < 0.05, **p < 0.01, ***p < 0.001, ****p < 0.0001, and ns denotes not significant