TY - JOUR
T1 - Value of texture analysis on gadoxetic acid–enhanced MRI for differentiating hepatocellular adenoma from focal nodular hyperplasia
AU - Cannella, Roberto
AU - Rangaswamy, Balasubramanya
AU - Minervini, Marta I.
AU - Borhani, Amir A.
AU - Tsung, Allan
AU - Furlan, Alessandro
N1 - Funding Information:
A. A. Borhani is a consultant for Guebert and has a book contract from Elsevier/Amirsys. A. Furlan is a consultant for GE Healthcare, received a research grant from GE Healthcare, and has a book contract from Elsevier/ Amirsys.
Publisher Copyright:
© American Roentgen Ray Society.
PY - 2019/3
Y1 - 2019/3
N2 - OBJECTIVE. The objective of our study was to assess the diagnostic performance of texture analysis (TA) on gadoxetic acid–enhanced MR images for differentiation of hepatocellular adenoma (HCA) from focal nodular hyperplasia (FNH). MATERIALS AND METHODS. This study included 40 patients (39 women and one man) with 51 HCAs and 28 patients (27 women and one man) with 32 FNH lesions. All lesions were histologically proven with preoperative MRI performed with gadoxetic acid. Two readers reviewed all the imaging sequences to assess the qualitative MRI characteristics. The T2-weighted fast spin-echo, hepatic arterial phase (HAP), and hepatobiliary phase (HBP) sequences were used for TA. Textural features were extracted using commercially available software (TexRAD). The differences in distributions of TA parameters of FNHs and HCAs were assessed using the Mann-Whitney U test. Area under the ROC curve (AUROC) values were calculated for statistically significant features. A logistic regression analysis was conducted to explore the added value of TA. A p value < 0.002 was considered statistically significant after Bonferroni correction for multiple comparisons. RESULTS. Multiple TA parameters showed a statistically different distribution in HCA and FNH including skewness on T2-weighted imaging, skewness on HAP imaging, skewness on HBP imaging, and entropy on HBP imaging (p < 0.001). Skewness on HBP imaging showed the largest AUROC (0.869; 95% CI, 0.777–0.933). A skewness value on HBP imaging of greater than –0.06 had a sensitivity of 72.5% and a specificity of 90.6% for the diagnosis of HCA. Six of 51 (11.8%) HCAs lacked hypointensity on HBP imaging. A binary logistic regression analysis including hypointensity on HBP imaging and the statistically significant TA parameters yielded an AUROC of 0.979 for the diagnosis of HCA and correctly predicted 96.4% of the lesions. CONCLUSION. TA may be of added value for the diagnosis of atypical HCA presenting without hypointensity on HBP imaging.
AB - OBJECTIVE. The objective of our study was to assess the diagnostic performance of texture analysis (TA) on gadoxetic acid–enhanced MR images for differentiation of hepatocellular adenoma (HCA) from focal nodular hyperplasia (FNH). MATERIALS AND METHODS. This study included 40 patients (39 women and one man) with 51 HCAs and 28 patients (27 women and one man) with 32 FNH lesions. All lesions were histologically proven with preoperative MRI performed with gadoxetic acid. Two readers reviewed all the imaging sequences to assess the qualitative MRI characteristics. The T2-weighted fast spin-echo, hepatic arterial phase (HAP), and hepatobiliary phase (HBP) sequences were used for TA. Textural features were extracted using commercially available software (TexRAD). The differences in distributions of TA parameters of FNHs and HCAs were assessed using the Mann-Whitney U test. Area under the ROC curve (AUROC) values were calculated for statistically significant features. A logistic regression analysis was conducted to explore the added value of TA. A p value < 0.002 was considered statistically significant after Bonferroni correction for multiple comparisons. RESULTS. Multiple TA parameters showed a statistically different distribution in HCA and FNH including skewness on T2-weighted imaging, skewness on HAP imaging, skewness on HBP imaging, and entropy on HBP imaging (p < 0.001). Skewness on HBP imaging showed the largest AUROC (0.869; 95% CI, 0.777–0.933). A skewness value on HBP imaging of greater than –0.06 had a sensitivity of 72.5% and a specificity of 90.6% for the diagnosis of HCA. Six of 51 (11.8%) HCAs lacked hypointensity on HBP imaging. A binary logistic regression analysis including hypointensity on HBP imaging and the statistically significant TA parameters yielded an AUROC of 0.979 for the diagnosis of HCA and correctly predicted 96.4% of the lesions. CONCLUSION. TA may be of added value for the diagnosis of atypical HCA presenting without hypointensity on HBP imaging.
KW - Focal nodular hyperplasia
KW - Hepatocellular adenoma
KW - MRI
KW - Texture analysis
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U2 - 10.2214/AJR.18.20182
DO - 10.2214/AJR.18.20182
M3 - Article
C2 - 30557050
AN - SCOPUS:85061980741
VL - 212
SP - 538
EP - 546
JO - The American journal of roentgenology and radium therapy
JF - The American journal of roentgenology and radium therapy
SN - 0361-803X
IS - 3
ER -