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Differentiation of Diffuse Large B-cell Lymphoma From Follicular Lymphoma Using Texture Analysis on Conventional MR
Xingchen Wu1, Minna Sikiö2, Hannu Pertovaara3
1Department of Oncology, Tampere University Hospital, Teiskontie 35, 33520 Tampere, Finland; Medical Imaging Centre, Department of Radiology, Tampere University Hospital, Tampere, Finland; School of Medicine, University of Tampere, Lääkärinkatu 1, 33520 Tampere, Finland.
Rational And Objectives:
Diffuse large B-cell lymphoma (DLBCL) represents the most common type of aggressive non-Hodgkin lymphoma (NHL); follicular lymphoma (FL) is the most frequent indolent NHL. The aim of this study was to investigate whether texture-based analysis of conventional magnetic resonance imaging (MRI) allows discrimination of DLBCL from FL, and further, to correlate the MRI texture features with diffusion-weighted imaging apparent diffusion coefficient (ADC) value and tumor tissue cellularity.
Materials And Methods:
Forty-one patients with histologically proven NHL (30 DLBCL and 11 FL) underwent conventional MRI and diffusion-weighted imaging examination before treatment. Based on regions of interest, texture analysis was performed on T1-weighted images pre- and postcontrast enhancement and on T2-weighted images with and without fat suppression, and features derived from the run-length matrix- and co-occurrence matrix-based methods were analyzed. Receiver operating characteristic curves were performed for the three most discriminative texture features for the differentiation of the two most common types of lymphoma. The analyzed MRI texture features were correlated with the ADC value and the tumor tissue cellularity.
Results:
We found that on T1-weighted images postcontrast enhancement, run-length matrix-based texture analysis for lesion classification differentiated DLBCL from FL, with specificity and sensitivity of 76.6% and 76.5%, respectively. There was no correlation between the texture features and the ADC value or tumor tissue cellularity.
Conclusions:
DLBCL and FL can be differentiated by means of texture analysis on T1-weighted MRI postcontrast enhancement. These results could serve as a basis for the use of the texture features on conventional MRI as adjunct to clinical examination to distinguish DLBCL from FL.
