By Lubner MG, et al. Abdom Radiol (NY). 2017. Source PubMed.
PURPOSE: To evaluate CT texture analysis (CTTA) for staging of hepatic fibrosis (stages F0-F4) METHODS: Quantitative texture analysis (QTA) of the liver was performed on abdominal MDCT scans using commercially available software (TexRAD), which uses a filtration-histogram statistic-based technique. Single-slice ROI measurements of the total liver, Couinaud segments IV-VIII, and segments I-III were obtained. CTTA parameters were correlated against fibrosis stage (F0-F4), with biopsy performed within one year for all cases with intermediate fibrosis (F1-F3).
RESULTS: The study cohort consisted of 289 adults (158M/131W; mean age, 51 years), including healthy controls (F0, n = 77), and patients with increasing stages of fibrosis (F1, n = 42; F2 n = 37; F3 n = 53; F4 n = 80). Mean gray-level intensity increased with fibrosis stage, demonstrating an ROC AUC of 0.78 at medium filtration for F0 vs F1-4, with sensitivity and specificity of 74% and 74% at cutoff 0.18. For significant fibrosis (≥F2), mean showed AUCs ranging from 0.71-0.73 across medium- and coarse- filtered textures with sensitivity and specificity of 71% and 68% at cutoff of 0.3, with similar performance also observed for advanced fibrosis (≥F3). Entropy showed a similar trend. Conversely, kurtosis and skewness decreased with increasing fibrosis, particularly in cirrhotic patients. For cirrhosis (≥F4), kurtosis and skewness showed AUCs of 0.86 and 0.87, respectively, at coarse-filtered scale, with skewness showing a sensitivity and specificity of 84% and 75% at cutoff of 1.3.
CONCLUSION: CTTA may be helpful in detecting the presence of hepatic fibrosis and discriminating between stages of fibrosis, particularly at advanced levels.
Dr Ganeshan, Director of New Business at Feedback Plc stated, “This study, and a number of others recently published in the run up to the European Congress of Radiology at the start of March serves to demonstrate the broad range of existing and potential new applications for TexRAD software. The recent high profile press coverage of MRI scan analysis for prostate cancer highlighted TexRAD’s potential to enhance early discovery of significant cancers. Similarly this study of texture analysis of the liver on routinely acquired CT scans highlights the potential of TexRAD to act as a non-invasive biomarker (tool) in the diagnosis of hepatic fibrosis and assessment of severity of the disease. This can potentially assist in minimising the need for frequent liver biopsies and additional examinations.”
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