Quantitative computed tomography texture analysis: can it improve diagnostic accuracy to differentiate malignant lymph nodes?

Cancer Imaging

Il Ki Hong¹  So Youn Shin²  Yong Suk Jo³ 

[1] 0000 0001 2171 7818, grid.289247.2, Department of Nuclear Medicine, Kyung Hee University Hospital, College of Medicine, Kyung Hee University, Seoul, Republic of Korea;0000 0001 2171 7818, grid.289247.2, Department of Radiology, Kyung Hee University Hospital, College of Medicine, Kyung Hee University, Seoul, Republic of Korea;0000 0001 2171 7818, grid.289247.2, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, KyungHee University Hospital, Seoul, Republic of Korea;0000 0004 0570 3602, grid.488451.4, Department of Internal Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, Republic of Korea;

关键词: Texture and shape analysis;    Mediastinal lymph node;    Malignancy;   

DOI  :  10.1186/s40644-019-0214-8

来源: publisher

【 摘 要 】

Background and objectiveMediastinal lymph node (LN) staging in individuals with non-small-cell lung cancer plays an important role in staging and treatment planning. This study aimed to assess the accuracy of computed tomography (CT) texture analysis (CTTA) in differentiating benign and malignant mediastinal LNs.MethodsPathologically confirmed malignant and benign mediastinal LN samples, obtained using endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), were retrospectively reviewed, in addition to chest CT and 18-fluorodeoxyglucose (FDG) uptake positron emission tomography (PET) data. For each LN, CTTA was performed using “AVIEW” software (Coreline Soft, Republic of Korea) by drawing a region of interest.ResultsA total of 132 LNs from 80 patients were included and classified into two groups according to pathology results: malignant (n = 61) and benign (n = 71). In EBUS, size > 1 cm, round shape, heterogeneous echogenicity, and presence of coagulation necrosis sign were more prevalent in malignant than in benign LNs; length was the only feature that distinguished the two groups. Among CTTA features, compactness and normalized standard deviation (SD) showed differences between the two groups. The ability to distinguish malignant LNs was higher using high standard uptake value (SUV) on FDG PET/CT (SUVmax ≥ 5) and normalized SD on CTTA (area under the receiver operating characteristic curve 0.739 versus 0.742, respectively); however, normalized SD demonstrated very low sensitivity despite high specificity.ConclusionsCTTA may be helpful in distinguishing between benign and malignant LNs; however, the diagnostic value was not high. Therefore, integrated evaluation with other imaging modalities is needed.

【 授权许可】

CC BY