Differentiating low and high grade mucoepidermoid carcinoma of the salivary glands using CT radiomics

Gland Surg. 2021 May;10(5):1646-1654. doi: 10.21037/gs-20-830.


Background: The purpose of this study is to determine if Haralick texture analysis on CT imaging of mucoepidermoid carcinomas (MEC) can differentiate low-grade and high-grade tumors.

Methods: A retrospective review of 18 patients with MEC of the salivary glands, corresponding CT imaging and pathology report was performed. Tumors were manually segmented and image analysis was performed to calculate radiomic features. Radiomic features were compared between low-grade and high-grade MEC. A multivariable logistic regression model and receiver operating characteristic analysis was performed.

Results: A total of 18 patients (mean age, 51, range 9-83 years, 8 men and 10 women) were included. Nine patients had low-grade pathology and nine patients had high-grade pathology. Of the 18 cases, 7 (39%) occurred in the parotid gland and 11 (61%) occurred in minor salivary glands. No individual feature was significantly different between low-grade and high-grade MEC. A logistic regression model including surface regularity, energy and information measure II of correlation was performed and was able to predict high-grade MEC accurately (sensitivity 89%, specificity 68%). The area under the receiver operating characteristic curve was 0.802.

Conclusions: High-grade MEC tend to have a low energy, high correlation texture as well as surface irregularity. Together, these three features may comprise a tumor phenotype that is able to predict high-grade pathology in MECs.

Keywords: CT; Salivary gland; grade; mucoepidermoid carcinoma (MEC); texture analysis.