European Radiology

, Volume 27, Issue 12, pp 4951–4959 | Cite as

Application of CT texture analysis in predicting histopathological characteristics of gastric cancers

  • Shunli Liu
  • Song Liu
  • Changfeng Ji
  • Huanhuan Zheng
  • Xia Pan
  • Yujuan Zhang
  • Wenxian Guan
  • Ling Chen
  • Yue Guan
  • Weifeng Li
  • Jian He
  • Yun Ge
  • Zhengyang Zhou



To explore the application of computed tomography (CT) texture analysis in predicting histopathological features of gastric cancers.


Preoperative contrast-enhanced CT images and postoperative histopathological features of 107 patients (82 men, 25 women) with gastric cancers were retrospectively reviewed. CT texture analysis generated: (1) mean attenuation, (2) standard deviation, (3) max frequency, (4) mode, (5) minimum attenuation, (6) maximum attenuation, (7) the fifth, 10th, 25th, 50th, 75th and 90th percentiles, and (8) entropy. Correlations between CT texture parameters and histopathological features were analysed.


Mean attenuation, maximum attenuation, all percentiles and mode derived from portal venous CT images correlated significantly with differentiation degree and Lauren classification of gastric cancers (r, −0.231 ~ −0.324, 0.228 ~ 0.321, respectively). Standard deviation and entropy derived from arterial CT images also correlated significantly with Lauren classification of gastric cancers (r = −0.265, −0.222, respectively). In arterial phase analysis, standard deviation and entropy were significantly lower in gastric cancers with than those without vascular invasion; however, minimum attenuation was significantly higher in gastric cancers with than those without vascular invasion.


CT texture analysis held great potential in predicting differentiation degree, Lauren classification and vascular invasion status of gastric cancers.

Key Points

CT texture analysis is noninvasive and effective for gastric cancer.

Portal venous CT images correlated significantly with differentiation degree and Lauren classification.

Standard deviation, entropy and minimum attenuation in arterial phase reflect vascular invasion.


Gastric cancer Multidetector computed tomography Pathology Diagnosis Medical oncology 



Area under the curve


Computed tomography


Hounsfield unit


Intraclass correlation coefficient


Receiver operating characteristic


Region of interest


Compliance with ethical standards


The scientific guarantor of this publication is Zhengyang Zhou.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.


This study has received funding by the National Natural Science Foundation of China (ID: 81371516, 81501441), Foundation of National Health and Family Planning Commission of China (W201306), Social Development Foundation of Jiangsu Province (BE2015605), the Natural Science Foundation of Jiangsu Province (ID: BK20131281, BK20150109), Jiangsu Province Health and Family Planning Commission Youth Scientific Research Project (ID: Q201508), and Six Talent Peaks Project of Jiangsu Province (ID: 2015-WSN-079).

Statistics and biometry

No complex statistical methods were necessary for this paper.

Ethical approval

Institutional Review Board approval was obtained.

Informed consent

Written informed consent was waived by the Institutional Review Board.


• retrospective

• diagnostic or prognostic study

• performed at one institution

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Copyright information

© European Society of Radiology 2017

Authors and Affiliations

  • Shunli Liu
    • 1
  • Song Liu
    • 1
  • Changfeng Ji
    • 1
  • Huanhuan Zheng
    • 1
  • Xia Pan
    • 1
  • Yujuan Zhang
    • 1
  • Wenxian Guan
    • 2
  • Ling Chen
    • 3
  • Yue Guan
    • 4
  • Weifeng Li
    • 4
  • Jian He
    • 1
  • Yun Ge
    • 4
  • Zhengyang Zhou
    • 1
  1. 1.Department of Radiology, Nanjing Drum Tower HospitalThe Affiliated Hospital of Nanjing University Medical SchoolNanjingChina
  2. 2.Department of Gastrointestinal Surgery, Nanjing Drum Tower HospitalThe Affiliated Hospital of Nanjing University Medical SchoolNanjingChina
  3. 3.Department of Pathology, Nanjing Drum Tower HospitalThe Affiliated Hospital of Nanjing University Medical SchoolNanjingChina
  4. 4.School of Electronic Science and EngineeringNanjing UniversityNanjingChina

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