Stocker Daniel, Marquez Herman P, Wagner Matthias W, Raptis Dimitri A, Clavien Pierre-Alain, Boss Andreas, Fischer Michael A, Wurnig Moritz C
Institute of Interventional and Diagnostic Radiology, University Hospital Zurich and University of Zurich, Zurich, Switzerland.
Department of Radiology, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain.
Heliyon. 2018 Nov 30;4(11):e00987. doi: 10.1016/j.heliyon.2018.e00987. eCollection 2018 Nov.
To find potentially diagnostic texture analysis (TA) features and to evaluate the diagnostic accuracy of two-dimensional (2D) magnetic resonance (MR) TA for differentiation between hepatocellular carcinoma (HCC) and benign hepatocellular tumors in the non-cirrhotic liver in an exploratory MR-study.
108 non-cirrhotic patients (62 female; 41.5 ± 18.3 years) undergoing preoperative contrast-enhanced MRI were retrospectively included in this multi-center-study. TA including gray-level histogram, co-occurrence and run-length matrix features (total 19 features) was performed by two independent readers. Native fat-saturated-T1w and T2w as well as arterial and portal-venous post contrast-enhanced 2D-image-slices were assessed. Conventional reading was performed by two separate independent readers. Differences in TA features between HCC and benign lesions were investigated using independent sample t-tests. Logistic regression analysis was performed to obtain the optimal number/combination of TA-features and diagnostic accuracy of TA analysis. Sensitivity and specificity of the better performing radiologist were compared to TA analysis.
The highest number of significantly differing TA-features (n = 5) was found using the arterial-phase images including one gray-level histogram (skewness, p = 0.018) and four run-length matrix features (all, p < 0.02). The optimal binary logistic regression model for TA-features of the arterial-phase images contained 13 parameters with an accuracy of 84.5% (sensitivity 84.1%, specificity 84.9%) and area-under-the-curve of 0.92 (95%-confidence-interval 0.85-0.98) for diagnosis of HCC. Conventional reading yielded a significantly lower sensitivity (63.6%, p = 0.027) and no significant difference in specificity (94.6%, p = 0.289) at best.
2D-TA of MR images is a feasible objective method that may help to distinguish HCC from benign hepatocellular tumors in the non-cirrhotic liver. Most promising results were found in TA features in the arterial phase images.
在一项探索性磁共振研究中，寻找潜在的诊断性纹理分析（TA）特征，并评估二维（2D）磁共振（MR）TA对非肝硬化肝脏中肝细胞癌（HCC）与良性肝细胞肿瘤进行鉴别的诊断准确性。
本多中心研究回顾性纳入了108例接受术前对比增强MRI检查的非肝硬化患者（62例女性；年龄41.5±18.3岁）。TA包括灰度直方图、共生矩阵和游程长度矩阵特征（共19个特征），由两名独立的阅片者进行分析。评估了平扫脂肪抑制T1加权像和T2加权像以及动脉期和门静脉期对比增强后的2D图像切片。传统阅片由两名独立的阅片者分别进行。使用独立样本t检验研究HCC与良性病变之间TA特征的差异。进行逻辑回归分析以获得TA特征的最佳数量/组合以及TA分析的诊断准确性。将表现较好的放射科医生的敏感性和特异性与TA分析进行比较。
在动脉期图像中发现显著不同的TA特征数量最多（n = 5），包括一个灰度直方图特征（偏度，p = 0.018）和四个游程长度矩阵特征（均p < 0.02）。动脉期图像TA特征的最佳二元逻辑回归模型包含13个参数，诊断HCC的准确率为84.5%（敏感性84.1%，特异性84.9%），曲线下面积为0.92（95%置信区间0.85 - 0.98）。传统阅片的敏感性显著较低（63.6%，p = 0.027），特异性最高时无显著差异（94.6%，p = 0.289）。
MR图像的2D-TA是一种可行的客观方法，可能有助于在非肝硬化肝脏中将HCC与良性肝细胞肿瘤区分开来。在动脉期图像的TA特征中发现了最有前景的结果。
