Rationale and objectives: Computed tomography (CT) after iodinated contrast agent injection is highly accurate for diagnosis of hepatic tumors. However, iodinating may have problems of renal toxicity and allergic reaction. We aimed to evaluate the potential role of the computer-aided diagnosis (CAD) with texture analysis in the differential of hepatic tumors on nonenhanced CT.
Materials and methods: This study evaluated 164 liver lesions (80 malignant tumors and 84 hemangiomas). The suspicious tumor region in the digitized CT image was manually selected and extracted as a circular subimage. Proposed preprocessing adjustments for subimages were used to equalize the information needed for a differential diagnosis. The autocovariance texture features of subimage were extracted and a support vector machine classifier identified the tumor as benign or malignant.
Results: The accuracy of the proposed diagnosis system for classifying malignancies is 81.7%, the sensitivity is 75.0%, the specificity is 88.1%, the positive predictive value is 85.7%, and the negative predictive value is 78.7%.
Conclusions: This system differentiates benign from malignant hepatic tumors with relative high accuracy and is therefore clinically useful to reduce patients needed for iodinated contrast agent injection in CT examination. Because the support vector machine is trainable, it could be further optimized if a larger set of tumor images is to be supplied.