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Feasibility of using computed tomography texture analysis parameters as imaging biomarkers for predicting risk grade of gastrointestinal stromal tumors: comparison with visual inspection

Authors
Choi, In YoungYeom, Suk KeuCha, JaehyungCha, Sang HoonLee, Seung HwaChung, Hwan HoonLee, Chang MinChoi, Jungwoo
Issue Date
7월-2019
Publisher
SPRINGER
Keywords
Computed tomography texture analysis; Gastrointestinal stromal tumor; Mitosis rate; Risk stratification
Citation
ABDOMINAL RADIOLOGY, v.44, no.7, pp.2346 - 2356
Indexed
SCIE
SCOPUS
Journal Title
ABDOMINAL RADIOLOGY
Volume
44
Number
7
Start Page
2346
End Page
2356
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/64267
DOI
10.1007/s00261-019-01995-4
ISSN
2366-004X
Abstract
PurposeTo evaluate the feasibility of using computed tomography texture analysis (CTTA) parameters for predicting malignant risk grade and mitosis index of gastrointestinal stromal tumors (GISTs), compared with visual inspection.Method and materialsCTTA was performed on portal phase CT images of 145 surgically confirmed GISTs (mean size: 42.937.5mm), using TexRAD software. Mean, standard deviation, entropy, mean of positive pixels (MPP), skewness, and kurtosis of CTTA parameters, on spatial scaling factor (SSF), 2-6 were compared by risk grade, mitosis rate, and the presence or absence of necrosis on visual inspection. CTTA parameters were correlated with risk grade. Diagnostic performance was evaluated with receiver operating characteristic curve analysis. Enhancement pattern, necrosis, heterogeneity, calcification, growth pattern, and mucosal ulceration were subjectively evaluated by two observers.ResultsThree to four parameters at different scales were significantly different according to the risk grade, mitosis rate, and the presence or absence of necrosis (p<0.041). MPP at fine or medium scale (r=-0.547 to -393) and kurtosis at coarse scale (r=0.424-0.454) correlated significantly with risk grade (p<0.001). HG-GIST was best differentiated from LG-GIST by MPP at SSF 2 (AUC, 0.782), and kurtosis at SSF 4 (AUC, 0.779) (all p<0.001). CT features predictive of HG-GIST were density lower than or equal to that of the erector spinae muscles on enhanced images (OR 2.1; p=0.037; AUC, 0.59), necrosis (OR, 6.1; p<0.001; AUC, 0.70), heterogeneity (OR, 4.3; p<0.001; AUC, 0.67), and mucosal ulceration (OR, 3.3; p=0.002; AUC, 0.62).Conclusion p id=Par4 Using TexRAD, MPP and kurtosis are feasible in predicting risk grade and mitosis index of GISTs. CTTA demonstrated meaningful accuracy in preoperative risk stratification of GISTs.
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