The Efficiency Of The Quantitative Parameters And Texture Analysis Of DCE-MRI In Diagnosis Of Benign And Malignant Liver Lesions

Objective: To investigate the diagnostic value of the quantitative parameter and the texture feature of Ktrans in differentiating benign and malignant lesions in liver,derived from dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI).Methods: DCE-MRI data of 60 patients with hepatic lesions confirmed by pathology or clinical diagnosis were collected.Quantitative parameters,such as the volume transfer constant(Ktrans),the interstitium-to-plasma rate constant(Kep),the volume fraction of extravascular extracellular space(Ve),the volume fraction of plasma(Vp),were taken by Dual-Input Extended Tofts-Kermode(ETK)model on a region of interest(ROI)in the workstations.Texture features,like Energy,Entropy,Skewness,Kurtosis,Uniformity,were extracted by gray-level Histogram.Independent-simple t test or Mann-Whitney U test was used for evaluating the significance of the difference between the benign and malignant liver lesions on quantitative parameters and texture features.The binary Logistic regression was used to fit joint diagnosis models,including Ktrans-Kep,Ktrans-Ve,Kep-Ve and Energy-Entropy,Energy-Skewness,Energy-Kurtosis,Entropy-Skewness,Entropy-Kurtosis,Skewness-Kurtosis,respectively.Then,the prediction frequency of each imaging index and corresponding joint diagnostic model was calculated.Receiver operating characteristic(ROC)curve,based on gold standard of pathology or clinical diagnosis,was draw with prediction frequency.The sensitivity and specificity of that were repectively discussed by the maximum Youden's index.Results: The quantitative parameters,as Ktrans,Kep and Ve,accord with normal distribution and homoscedasticity.Ve accords with normal distribution,but not homoscedasticity.Ktrans,Kep of malignant lesions group(1.233±0.613,1.777±0.848)was significantly higher than that of benign lesion group(0.532±0.371,0.942±1.151)(Independent-simple t test,t =?5.064,?3.004 P =0.000,0.004),then Ve of benign lesion group(4.343±2.996)was significantly higher than that of malignant lesions group(1.271±0.675)(Mann-Whitney U test,P =0.000).There was no statistically significant difference between benign lesions group(0.219±0.267)and malignant lesions group(0.332 ± 0.243)in Vp(Independent-simple t test,t =?1.601,P =0.116).The area under the ROC curve of each quantitative parameter and joint diagnostic model was 0.841(Ktrans),0.848(Ve),0.815(Kep),0.844(Ktrans-Kep),0.929(Ktrans-Ve),0.808(Kep-Ve).The efficiency of Ktrans-Ve was the best.The maximum Youden's index had indicated that the specificity is highest(100%).The efficiency of Ve is inferior to that of Ktrans-Ve,but the sensitivity of Ve is highest(85.7%).All of the texture features are subject to normal distribution and homoscedasticity.Energy,Kurtosis of malignant lesions group(0.610±0.265,1.126±0.751)was lower than that of benign lesion group(0.762±0.264,2.100±0.894)(Independent-simple t test,t =?2.022,?4.187,P =0.049,0.000).Entropy,Skewness of malignant lesions group(1.056±0.683,0.489±0.579)was higher than that of benign lesion group(0.658±0.695,0.244±0.583)(Independent-simple t test,t =2.033,4.450,P =0.048,0.000).There was no statistically significant difference between benign lesions group(?0.555±0.607)and malignant lesions group(? 0.543 ± 0.432)in Uniformity(Independent-simple t test,t =0.067,P =0.947).AUC of each texture feature and joint diagnostic model is 0.654(Energy),0.645(Entropy),0.825(Skewness),0.828(Kurtosis),0.643(Energy-Entropy),0.857(Energy-Skewness),0.842(Energy-Kurtosis),0.835(Entropy-Skewness),0.842(Entropy-Kurtosis),0.839(Skewness-Kurtosis).The ROC curve of the groups,such as Energy,Entropy,Energy-Entropy is without statistically significant difference.The efficiency of Energy-Skewness is the best.Based with the maximum Youden's index,the specificity of Skewness,Energy-Skewness,Entropy-Skewness,Entropy-Kurtosis is the highest(87.0%).The sensitivity of Kurtosis,Energy-Skewness,Energy-Kurtosis,Entropy-Skewness is the highest(81.5%).Conclusion: Quantitative parameters of Ktrans,Kep and Ve and texture features of Energy,Entropy,Skewness,Kurtosis,can be an effective image index to different the benign and malignant lesions of the liver.On the contrary,the value of Vp and Uniformity is not confirmed.With higher efficiency and specificity for each index group,Ktrans-Ve and Energy-Skewness are superior to other index or joint diagnosis models in differentiating the benign and malignant lesions of the liver.