Abstract
This study aims to investigate the influence of interobserver manual segmentation variability on the reproducibility of 2D and 3D unenhanced computed tomography (CT)- and magnetic resonance imaging (MRI)-based texture analysis. Thirty patients with cartilaginous bone tumors (10 enchondromas, 10 atypical cartilaginous tumors, 10 chondrosarcomas) were retrospectively included. Three radiologists independently performed manual contour-focused segmentation on unenhanced CT and T1-weighted and T2-weighted MRI by drawing both a 2D region of interest (ROI) on the slice showing the largest tumor area and a 3D ROI including the whole tumor volume. Additionally, a marginal erosion was applied to both 2D and 3D segmentations to evaluate the influence of segmentation margins. A total of 783 and 1132 features were extracted from original and filtered 2D and 3D images, respectively. Intraclass correlation coefficient ≥ 0.75 defined feature stability. In 2D vs. 3D contour-focused segmentation, the rates of stable features were 74.71% vs. 86.57% (p < 0.001), 77.14% vs. 80.04% (p = 0.142), and 95.66% vs. 94.97% (p = 0.554) for CT and T1-weighted and T2-weighted images, respectively. Margin shrinkage did not improve 2D (p = 0.343) and performed worse than 3D (p < 0.001) contour-focused segmentation in terms of feature stability. In 2D vs. 3D contour-focused segmentation, matching stable features derived from CT and MRI were 65.8% vs. 68.7% (p = 0.191), and those derived from T1-weighted and T2-weighted images were 76.0% vs. 78.2% (p = 0.285). 2D and 3D radiomic features of cartilaginous bone tumors extracted from unenhanced CT and MRI are reproducible, although some degree of interobserver segmentation variability highlights the need for reliability analysis in future studies.
Highlights
Cartilaginous tumors of the bone include a broad spectrum of lesions that range from benign to malignant entities [1, 2]
Asymptomatic benign enchondromas do not require any treatment, appendicular atypical cartilaginous tumors are managed with intralesional curettage or even watchful waiting, and appendicular higher grade lesions and axial skeleton chondrosarcomas are resected with free margins [3]
The aim of this study is to investigate the influence of interobserver manual segmentation variability on the reproducibility of bidimensional (2D) and volumetric (3D) unenhanced computed tomography (CT)- and magnetic resonance imaging (MRI)-based texture analysis in cartilaginous bone tumors
Summary
Cartilaginous tumors of the bone include a broad spectrum of lesions that range from benign to malignant entities [1, 2]. Reliable identification and grading are crucial, as clinical management varies widely. Asymptomatic benign enchondromas do not require any treatment, appendicular atypical cartilaginous tumors are managed with intralesional curettage or even watchful waiting, and appendicular higher grade lesions and axial skeleton chondrosarcomas are resected with free margins [3]. The diagnosis relies on a combination of clinical presentation, imaging, and biopsy [3, 4]. Magnetic resonance imaging (MRI), has good accuracy in discriminating atypical cartilaginous tumors from higher grade lesions [5] but is less reliable in differentiating the former from enchondromas [6]. The need for cutting-edge imaging-based tools, such as radiomics, is advocated to safely diagnose and grade cartilaginous bone tumors non-invasively [9]
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