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Evaluation of texture analysis for the differential diagnosis of focal nodular hyperplasia from hepatocellular adenoma on contrast-enhanced CT images

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Abstract

Purpose

To explore the value of CT texture analysis (CTTA) for differentiation of focal nodular hyperplasia (FNH) from hepatocellular adenoma (HCA) on contrast-enhanced CT (CECT).

Methods

This is a retrospective, IRB-approved study conducted in a single institution. A search of the medical records between 2008 and 2017 revealed 48 patients with 70 HCA and 50 patients with 62 FNH. All lesions were histologically proven and with available pre-operative CECT imaging. Hepatic arterial phase (HAP) and portal venous phase (PVP) were used for CTTA. Textural features were extracted using a commercially available research software (TexRAD). The differences between textural parameters of FNH and HCA were assessed using the Mann–Whitney U test and the AUROC were calculated. CTTA parameters showing significant difference in rank sum test were used for binary logistic regression analysis. A p value < 0.05 was considered statistically significant.

Results

On HAP images, mean, mpp, and skewness were significantly higher in FNH than in HCA on unfiltered images (p ≤ 0.007); SD, entropy, and mpp on filtered analysis (p ≤ 0.006). On PVP, mean, mpp, and skewness in FNH were significantly different from HCA (p ≤ 0.001) on unfiltered images, while entropy and kurtosis were significantly higher in FNH on filtered images (p ≤ 0.018). The multivariate logistic regression analysis indicated that the mean, mpp, and entropy of medium-level and coarse-level filtered images on HAP were independent predictors for the diagnosis of HCA and a model based on all these parameters showed the largest AUROC (0.824).

Conclusions

Multiple explored CTTA parameters are significantly different between FNH and HCA on CECT.

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Authors and Affiliations

  1. Abdominal Imaging Division, Department of Radiology, University of Pittsburgh, 200 Lothrop Street, Pittsburgh, PA, 15213, USA

    Roberto Cannella, Amir A. Borhani & Alessandro Furlan

  2. Section of Radiology - Di.Bi.Med, University Hospital “Paolo Giaccone”, Via del Vespro 127, 90127, Palermo, Italy

    Roberto Cannella

  3. Division of Transplantation and Liver Pathology, Department of Anatomic Pathology, University of Pittsburgh, Pittsburgh, PA, USA

    Marta I. Minervini

  4. Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, University of Pittsburgh, Pittsburgh, PA, USA

    Allan Tsung

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  1. Roberto Cannella
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  2. Amir A. Borhani
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  3. Marta I. Minervini
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  4. Allan Tsung
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  5. Alessandro Furlan
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Corresponding author

Correspondence to Alessandro Furlan.

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No funding was received for this study.

Conflict of interest

The authors declare that they have no conflict of interests.

Disclosure

Alessandro Furlan: research grant from General Electric; consultant for General Electric; book contract with Elsevier/Amirsys. Amir A. Borhani: consultant for Guebert; consultant for Elsevier/Amirsys.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Cite this article

Cannella, R., Borhani, A.A., Minervini, M.I. et al. Evaluation of texture analysis for the differential diagnosis of focal nodular hyperplasia from hepatocellular adenoma on contrast-enhanced CT images. Abdom Radiol 44, 1323–1330 (2019). https://doi.org/10.1007/s00261-018-1788-5

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  • DOI: https://doi.org/10.1007/s00261-018-1788-5

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