Evaluation of texture analysis for the differential diagnosis of focal nodular hyperplasia from hepatocellular adenoma on contrast-enhanced CT images

PurposeTo explore the value of CT texture analysis (CTTA) for differentiation of focal nodular hyperplasia (FNH) from hepatocellular adenoma (HCA) on contrast-enhanced CT (CECT).MethodsThis is a retrospective, IRB-approved study conducted in a single institution. A search of the medical records between 2008 and 2017 revealed 48 patients with 70 HCA and 50 patients with 62 FNH. All lesions were histologically proven and with available pre-operative CECT imaging. Hepatic arterial phase (HAP) and portal venous phase (PVP) were used for CTTA. Textural features were extracted using a commercially available research software (TexRAD). The differences between textural parameters of FNH and HCA were assessed using the Mann-Whitney U test and the AUROC were calculated. CTTA parameters showing significant difference in rank sum test were used for binary logistic regression analysis. A p value<0.05 was considered statistically significant.ResultsOn HAP images, mean, mpp, and skewness were significantly higher in FNH than in HCA on unfiltered images (p0.007); SD, entropy, and mpp on filtered analysis (p0.006). On PVP, mean, mpp, and skewness in FNH were significantly different from HCA (p0.001) on unfiltered images, while entropy and kurtosis were significantly higher in FNH on filtered images (p0.018). The multivariate logistic regression analysis indicated that the mean, mpp, and entropy of medium-level and coarse-level filtered images on HAP were independent predictors for the diagnosis of HCA and a model based on all these parameters showed the largest AUROC (0.824).ConclusionsMultiple explored CTTA parameters are significantly different between FNH and HCA on CECT.