Abstract
Objectives: This study was designed to estimate the performance of textural features derived from contrast-enhanced CT in the differential diagnosis of pancreatic serous cystadenomas and pancreatic mucinous cystadenomas.Methods: Fifty-three patients with pancreatic serous cystadenoma and 25 patients with pancreatic mucinous cystadenoma were included. Textural parameters of the pancreatic neoplasms were extracted using the LIFEx software, and were analyzed using random forest and Least Absolute Shrinkage and Selection Operator (LASSO) methods. Patients were randomly divided into training and validation sets with a ratio of 4:1; random forest method was adopted to constructed a diagnostic prediction model. Scoring metrics included sensitivity, specificity, accuracy, and AUC.Results: Radiomics features extracted from contrast-enhanced CT were able to discriminate pancreatic mucinous cystadenomas from serous cystadenomas in both the training group (slice thickness of 2 mm, AUC 0.77, sensitivity 0.95, specificity 0.83, accuracy 0.85; slice thickness of 5 mm, AUC 0.72, sensitivity 0.90, specificity 0.84, accuracy 0.86) and the validation group (slice thickness of 2 mm, AUC 0.66, sensitivity 0.86, specificity 0.71, accuracy 0.74; slice thickness of 5 mm, AUC 0.75, sensitivity 0.85, specificity 0.83, accuracy 0.83).Conclusions: In conclusion, our study provided preliminary evidence that textural features derived from CT images were useful in differential diagnosis of pancreatic mucinous cystadenomas and serous cystadenomas, which may provide a non-invasive approach to determine whether surgery is needed in clinical practice. However, multicentre studies with larger sample size are needed to confirm these results.
Highlights
Pancreatic cysts can be classified into non-neoplastic and neoplastic subtypes [1]
We firstly evaluated the performance of threedimensional texture analysis based on contrast-enhanced Computed tomography (CT) images in the differential diagnosis of pancreatic mucinous cystadenomas and serous cystadenomas
Fifteen-three patients with serous cystadenoma and 25 patients with mucinous cystadenoma were included in this study
Summary
Pancreatic cysts can be classified into non-neoplastic and neoplastic subtypes [1]. Mucinous cystadenomas, and intraductal papillary mucinous neoplasms constitute a majority of the neoplastic subtype encountered in practice [2, 3]. Serous cystadenomas are glycogen-rich lesions arising from cuboidal epithelium, which are considered benign and are most found incidentally [4, 5]. Given the benign nature of serous cystadenomas, surgical intervention is conserved unless symptomatic or the diagnosis remains doubtful. The diagnosis of mucinous cystadenomas rests on the presence of ovarian-type stroma. About 76% of the patients with mucinous cystadenoma are symptomatic at the time of diagnosis, and the most common symptom is non-specific abdominal pain [7]. In contrast to serous cystadenomas, mucinous cystadenomas have considerable malignant potential, and guidelines recommend resection for all surgically fit patients. In consideration of the different treatment principles of the two diseases, preoperative differential diagnosis is crucial
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