J Cancer 2018; 9(19):3577-3582. doi:10.7150/jca.26356

Research Paper

Adrenal incidentaloma: machine learning-based quantitative texture analysis of unenhanced CT can effectively differentiate sPHEO from lipid-poor adrenal adenoma

Xiaoping Yi1,2#, Xiao Guan3#, Chen Chen4#, Youming Zhang1, Zhe Zhang1, Minghao Li3, Peihua Liu3, Anze Yu3, Xueying Long1✉, Longfei Liu3✉, Bihong T Chen5, Chishing Zee6

1. Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan province, P.R.China;
2. Postdoctoral Research Workstation of Pathology and Pathophysiology, Basic Medical Sciences, Xiangya Hospital, Central South University, P. R, China;
3. Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan province, P.R.China;
4. Department of Radiology, ZhuZhou 331 Hospital, Changsha Medical University, Changsha, Hunan province, P.R.China;
5. Department of Diagnostic Radiology, City of Hope National Medical Center, Duarte, California, U. S. A;
6. Department of Radiology, Keck Medical Center of USC, Los Angeles, CA.
# Xiaoping Yi, Xiao Guan, and Chen Chen contributed equally to this work.

Abstract

Objective: To evaluate the feasibility and accuracy of machine learning based texture analysis of unenhanced CT images in differentiating subclinical pheochromocytoma (sPHEO) from lipid-poor adenoma (LPA) in adrenal incidentaloma (AI).

Methods: Seventy-nine patients with 80 LPA and 29 patients with 30 sPHEO were included in the study. Texture parameters were derived using imaging software (MaZda). Thirty texture features were selected and LPA was performed for the features selected. The number of positive features was used to predict results. Logistic multiple regression analysis was performed on the 30 texture features, and a predictive equation was created based on the coefficients obtained.

Results: LPA yielded a misclassification rate of 19.39% in differentiating sPHEO from LPA. Our predictive model had an accuracy rate of 94.4% (102/108), with a sensitivity of 86.2% (25/29) and a specificity of 97.5% (77/79) for differentiation. When the number of positive features was greater than 8, the accuracy of prediction was 85.2% (92/108), with a sensitivity of 96.6% (28/29) and a specificity of 81% (64/79).

Conclusions: Machine learning-based quantitative texture analysis of unenhanced CT may be a reliable quantitative method in differentiating sPHEO from LPA when AI is present.

Keywords: Texture analysis, adrenal incidentaloma, sPHEO, lipid-poor adrenal adenoma, differentiation.

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How to cite this article:
Yi X, Guan X, Chen C, Zhang Y, Zhang Z, Li M, Liu P, Yu A, Long X, Liu L, Chen BT, Zee C. Adrenal incidentaloma: machine learning-based quantitative texture analysis of unenhanced CT can effectively differentiate sPHEO from lipid-poor adrenal adenoma. J Cancer 2018; 9(19):3577-3582. doi:10.7150/jca.26356. Available from http://www.jcancer.org/v09p3577.htm