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Cited by 65Radiomics and Machine Learning in Medical ImagingAI in cancer detectionImage Retrieval and Classification Techniques

Can texture analysis be used to distinguish benign from malignant adrenal nodules on unenhanced CT, contrast-enhanced CT, or in-phase and opposed-phase MRI?

Ho, Lisa M., Samei, Ehsan, Mazurowski, Maciej A., Zheng, Yuese, Allen, Brian C., Nelson, Rendon C., Marin, Daniele·2019·American Journal of Roentgenology
DOI 10.2214/ajr.18.20097
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Abstract

OBJECTIVE: The purpose of this study is to determine whether second-order texture analysis can be used to distinguish lipid-poor adenomas from malignant adrenal nodules on unenhanced CT, contrast-enhanced CT (CECT), and chemical-shift MRI. MATERIALS AND METHODS: In this retrospective study, 23 adrenal nodules (15 lipid-poor adenomas and eight adrenal malignancies) in 20 patients (nine female patients and 11 male patients; mean age, 59 years [range, 15-80 years]) were assessed. All patients underwent unenhanced CT, CECT, and chemical-shift MRI. Twenty-one second-order texture features from the gray-level cooccurrence matrix and gray-level run-length matrix were calculated in 3D. The mean values for 21 texture features and four imaging features (lesion size, unenhanced CT attenuation, CECT attenuation, and signal intensity index) were compared using a t test. The diagnostic performance of texture analysis versus imaging features was also compared using AUC values. Multivariate logistic regression models to predict malignancy were constructed for texture analysis and imaging features. RESULTS: Lesion size, unenhanced CT attenuation, and the signal intensity index showed significant differences between benign and malignant adrenal nodules. No significant difference was seen for CECT attenuation. Eighteen of 21 CECT texture features and nine of 21 unenhanced CT texture features revealed significant differences between benign and malignant adrenal nodules. CECT texture features (mean AUC value, 0.80) performed better than CECT attenuation (mean AUC value, 0.60). Multivariate logistic regression models showed that CECT texture features, chemical-shift MRI texture features, and imaging features were predictive of malignancy. CONCLUSION: Texture analysis has a potential role in distinguishing benign from malignant adrenal nodules on CECT and may decrease the need for additional imaging studies in the workup of incidentally discovered adrenal nodules.

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  • Other groups have shown similar results in small retrospective series evaluating the accuracy of MRI and PET-CT textural features for distinguishing benign and malignant adrenal lesions.

    “Other groups have shown similar results in small retrospective series evaluating the accuracy of MRI and PET-CT textural features for distinguishing benign and malignant adrenal lesions (380,381).”

    From Adrenal incidentaloma (2020) · cites this paper as [380]

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Authors
Ho, L. M., Samei, E., Mazurowski, M. A., Zheng, Y., Allen, B. C., Nelson, R. C., & Marin, D.
Affiliations
  • Duke Medical Center (US)
  • Duke University (US)
ORCID
Venue
American Journal of Roentgenology
Publisher
American Roentgen Ray Society
Published
2019-03
Volume
212
Issue
3
Pages
554-561
ISSN
  • 0002-9580 (ISSN-L)
  • 0361-803X
  • 1546-3141
DOI
10.2214/ajr.18.20097
OpenAlex
W2910492523
Cited by
65
References
30
Citations by year
2026: 6 · 2025: 6 · 2024: 6 · 2023: 9 · 2022: 18 · 2021: 12 · 2020: 6 · 2019: 2
FWCI
6.27
Type
journal article
Language
en
Open access
closed
Locations
  • American Journal of Roentgenology (publishedVersion, public-domain)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiomics and Machine Learning in Medical Imaging
  • Physical Sciences › Computer Science › Artificial Intelligence › AI in cancer detection
  • Physical Sciences › Computer Science › Computer Vision and Pattern Recognition › Image Retrieval and Classification Techniques
Keywords
adrenal nodules, adrenal adenoma, adrenal malignancy, texture analysis, gray level co-occurrence matrix, gray level run length matrix, contrast-enhanced CT, chemical shift MRI, benign versus malignant differentiation, incidental adrenal findings
MeSH terms
Adenoma, Adolescent, Adrenal Gland Neoplasms, Adult, Aged, Aged, 80 and over, Contrast Media, Diagnosis, Differential, Female, Humans, Image Interpretation, Computer-Assisted, Magnetic Resonance Imaging, Male, Middle Aged, Retrospective Studies, Tomography, X-Ray Computed

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