Complementary Role of Computed Tomography Texture Analysis for Differentiation of Hepatocellular Carcinoma from Intrahepatic Peripheral Cholangiocellular Carcinoma on Single Portal-Venous Phase Computed Tomography

Abstract

Purpose: To assess the role of CT-textural features for differentiation of hepatocellular carcinoma (HCC) from intrahepatic peripheral cholangiocellular carcinoma (CCC) on single portal-venous phase contrast-enhanced CT whilst identifying the most significant discriminatory features.Methods: 61 consecutive patients (mean age, 66.7 years; range, 38.0-88.7 years; 45 males) with newly diagnosed, biopsy-proven HCC (n=33) and CCC (n=28), who all received a portal-venous phase contrast-enhanced CT (CECT) for primary staging, were evaluated in this study. Using a standardized imaging protocol, volumes of interests (VOIs) were set in the tumor tissue excluding adjacent structures. Based on pyradiomics library, a total of 35 textural features were extracted from the VOIs, including 1 st , 2 nd and higher order features, and then compared between HCC and CCC. Additionally, a tumor-to-liver ratio was calculated using ROIs set in the same position as for CT-textural analysis.Results: A highly significant difference (p<0.005) between HCC and CCC was observed for 1 st order features Mean and Median. First order feature Maximum and 2 nd order feature grey-level co-occurrence matrix inverse difference moment normalized (glcm Idmn) differed also significantly (p<0.05). Most combinations of the primarily highly significant features (Mean, Median) with other textural features also showed very good significance levels (p<0.005).