title: Differentiation of pyogenic hepatic abscesses from malignant mimickers using multislice-based texture acquired from contrast-enhanced computed tomography.
abstract: BACKGROUND
  Pyogenic hepatic abscess may mimic primary or secondary carcinoma of the liver on contrast-enhanced computed tomography (CECT). The present study was to explore the usefulness of the analysis of multislice-based texture acquired from CECT in the differentiation between pyogenic hepatic abscesses and malignant mimickers.
  
  
  METHODS
  This retrospective study included 25 abscesses in 20 patients and 33 tumors in 26 subjects who underwent CECT. To make comparison, we also enrolled 19 patients with hepatic single simple cyst. The images from CECT were analyzed using a Laplacian of Gaussian band-pass filter (5 filter levels with sigma weighting ranging from 1.0 to 2.5). We also quantified the uniformity, entropy, kurtosis and skewness of the multislice-based texture at different sigma weightings. Statistical significance for these parameters was tested with one-way ANOVA followed by Tukey honestly significant difference (HSD) test. Diagnostic performance was evaluated using the receiver operating characteristic (ROC) curve analysis.
  
  
  RESULTS
  There were significant differences in entropy and uniformity at all sigma weightings (P<0.001) among hepatic abscesses, malignant mimickers and simple cysts. The significant difference in kurtosis and skewness was shown at sigma 1.8 and 2.0 weightings (P=0.002-0.006). Tukey HSD test showed that the abscesses had a significantly higher entropy and lower uniformity compared with malignant mimickers (P=0.000-0.004). Entropy (at a sigma 2.0 weighting) had the largest area under the ROC curve (0.888) in differentiating abscesses from malignant mimickers, with a sensitivity of 81.8% and a specificity of 88.0% when the cutoff value was set to 3.64.
  
  
  CONCLUSIONS
  Multislice-based texture analysis may be useful for differentiating pyogenic hepatic abscesses from malignant mimickers.
authors: Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China. xujianrong_renji@163.com.
authors: Shi-Teng
authors: ST
authors: Suo
authors: Zhi-Guo
authors: ZG
authors: Zhuang
authors: Meng-Qiu
authors: MQ
authors: Cao
authors: Li-Jun
authors: LJ
authors: Qian
authors: Xin
authors: X
authors: Wang
authors: Run-Lin
authors: RL
authors: Gao
authors: Yu
authors: Y
authors: Fan
authors: Jian-Rong
authors: JR
authors: Xu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D003287:Contrast Media / Q000008:administration & dosage*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007472:Iohexol / Q000008:administration & dosage / Q000031:analogs & derivatives*; D046290:Liver Abscess, Pyogenic / Q000000981:diagnostic imaging*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D015588:Observer Variation; D011237:Predictive Value of Tests; D012372:ROC Curve; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies
chemical_list: D003287:Contrast Media; D007472:Iohexol; C038192:iopromide