Diagnostic and Interventional Radiology
Abdominal Imaging - Original Article

Evaluating the added benefit of CT texture analysis on conventional CT analysis to differentiate benign ovarian cysts

1.

Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, the Catholic University of Korea, Seoul, Republic of Korea

2.

Department of Radiology, Eunpyeong St. Mary's Hospital, College of Medicine, the Catholic University of Korea, Seoul, Republic of Korea

3.

Catholic Smart Imaging Center, Eunpyeong St. Mary's Hospital, College of Medicine, the Catholic University of Korea, Seoul, Republic of Korea

Diagn Interv Radiol 2021; 27: 460-468
DOI: 10.5152/dir.2021.20225
Read: 575 Downloads: 74 Published: 29 July 2020

PURPOSE 
We aimed to evaluate the benefit of adding CT texture analysis on conventional CT features of benign adnexal cystic lesions, especially in identifying mucinous cystadenoma.

METHODS
This retrospective study included patients who underwent surgical removal of benign ovarian cysts (44 mucinous cystadenomas, 32 serous cystadenomas, 16 follicular/simple cysts and 43 endometriotic cysts) at our institution between January 2015 and November 2017. The CT images were independently reviewed by an abdominal radiologist (reviewer 1) and a resident (reviewer 2). Both reviewers recorded the conventional characteristics and performed texture analysis. Based on reviewer 1’s results, two decision trees for differential diagnosis were developed. Reviewer 2’s results were then applied to the decision trees. The diagnostic performances of each reviewer with and without the decision trees were compared.

RESULTS
Several conventional features and texture analysis parameters showed significant differences between mucinous cystadenomas and other benign adnexal cysts. The first decision tree selected septum number and thickness as significant features, whereas the second decision tree selected septum number and the mean values at spatial scaling factor (SSF) 0. Reviewer 1’s performance did not change significantly with or without the use of the decision trees. Reviewer 2’s interpretations were significantly less sensitive than reviewer 1’s interpretations (p = 0.001). However, when aided by the first and second decision trees, Reviewer 2’s interpretations were significantly more sensitive than reviewer 1’s interpretations (86.4%, p < 0.001; 72.7%, p = 0.001). 

CONCLUSION
This study suggests the benefit of CT texture analysis on conventional images to differentiate mucinous cystadenoma from other benign adnexal cysts, particularly for less experienced radiologists.

You may cite this article as: Seo M, Choi MH, Lee YJ, Jung SE, Rha SE. Evaluating the added benefit of CT texture analysis on conventional CT analysis to differentiate benign ovarian cysts. Diagn Interv Radiol 2021; 27:460-468
 

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