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Pilot study to differentiate lipoma from atypical lipomatous tumour/well-differentiated liposarcoma using MR radiomics-based texture analysis

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Abstract

Aims

This pilot study aims to determine if tumour heterogeneity assessed using magnetic resonance imaging (MRI) radiomics-based texture analysis (TA) can differentiate between lipoma and atypical lipomatous tumour (ALT)/well-differentiated liposarcoma (WDL).

Materials and methods

Thirty consecutive ALT/WDLs and 30 lipomas were included in the study, cases diagnosed both histologically and with murine double minute 2 (MDM2) gene amplification by fluorescence in situ hybridisation (FISH) in excision specimens. Multiple patient, MRI and MRTA factors were assessed. Heterogeneity was evaluated using a filtration-histogram technique-based textural analysis on single axial proton density (PD) and coronal T1-W images of the most homogenously fatty component of the lesion.

Results

Thirty-three percent of the diagnoses of ALT/WDL vs lipoma were confirmed using FISH MDM2 analysis. ALT/WDLs were statistically different from lipomas in location (site in the body and depth from skin surface) and fat content, with p values of 0.021, 0.001, and 0.021 respectively. Nine of 36 (25%) texture parameters had significant differences between ALT/WDLs and lipomas on axial PD MRTA, with the most significant results at medium and coarse texture scales particularly mean intensity (p = 0.003) at SSF = 6, and kurtosis (p = 0.012) at SSF = 5. A cut-off value of < 304 for coarse-filtered texture on axial PD MRI identified ALT from lipoma with a sensitivity and specificity of 70% (AUC = 0.73, p = 0.003).

Conclusions

Texture heterogeneity quantified at fine, medium, and coarse texture scales are significant differentiators of lipoma and ALT/WDL with the difference particularly marked in medium and coarse texture scales for two MR TA parameters: mean and kurtosis.

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Authors and Affiliations

  1. Clinical Radiology, Royal National Orthopaedic Hospital, Stanmore, UK

    Ian Pressney, Michael Khoo & Paul O’Donnell

  2. Department of Radiology, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK

    Ian Pressney

  3. Nuclear Medicine, University College Hospital, London, UK

    Raymond Endozo & Balaji Ganeshan

  4. Institute of Orthopaedics and Musculoskeletal Science, University College, London, London, UK

    Paul O’Donnell

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  1. Ian Pressney
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  2. Michael Khoo
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  4. Balaji Ganeshan
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Correspondence to Ian Pressney.

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Conflict of interest

One of the authors (Balaji Ganeshan) is the Co-Founder/Co-Inventor of TexRad texture analysis software used in this study and a shareholder of Feedback Plc (Feedback Medical Ltd is the operating company owned by Feedback Plc.), a UK based company which owns, develops and markets the TexRAD texture analysis software.

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Pressney, I., Khoo, M., Endozo, R. et al. Pilot study to differentiate lipoma from atypical lipomatous tumour/well-differentiated liposarcoma using MR radiomics-based texture analysis. Skeletal Radiol 49, 1719–1729 (2020). https://doi.org/10.1007/s00256-020-03454-4

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