Pressney, I;
Khoo, M;
Endozo, R;
Ganeshan, B;
O'Donnell, P;
(2020)
Pilot study to differentiate lipoma from atypical lipomatous tumour/well-differentiated liposarcoma using MR radiomics-based texture analysis.
Skeletal Radiology
, 49
pp. 1719-1729.
10.1007/s00256-020-03454-4.
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Abstract
AIMS: This pilot study aims to determine if tumour heterogeneity assessed using magnetic resonance imaging (MRI) radiomics-based texture analysis (TA) can differentiate between lipoma and atypical lipomatous tumour (ALT)/well-differentiated liposarcoma (WDL). MATERIALS AND METHODS: Thirty consecutive ALT/WDLs and 30 lipomas were included in the study, cases diagnosed both histologically and with murine double minute 2 (MDM2) gene amplification by fluorescence in situ hybridisation (FISH) in excision specimens. Multiple patient, MRI and MRTA factors were assessed. Heterogeneity was evaluated using a filtration-histogram technique-based textural analysis on single axial proton density (PD) and coronal T1-W images of the most homogenously fatty component of the lesion. RESULTS: Thirty-three percent of the diagnoses of ALT/WDL vs lipoma were confirmed using FISH MDM2 analysis. ALT/WDLs were statistically different from lipomas in location (site in the body and depth from skin surface) and fat content, with p values of 0.021, 0.001, and 0.021 respectively. Nine of 36 (25%) texture parameters had significant differences between ALT/WDLs and lipomas on axial PD MRTA, with the most significant results at medium and coarse texture scales particularly mean intensity (p = 0.003) at SSF = 6, and kurtosis (p = 0.012) at SSF = 5. A cut-off value of < 304 for coarse-filtered texture on axial PD MRI identified ALT from lipoma with a sensitivity and specificity of 70% (AUC = 0.73, p = 0.003). CONCLUSIONS: Texture heterogeneity quantified at fine, medium, and coarse texture scales are significant differentiators of lipoma and ALT/WDL with the difference particularly marked in medium and coarse texture scales for two MR TA parameters: mean and kurtosis.
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