Related Experiment Video For Computed tomography (CT)
Updated: Feb 16, 2026
Establishment and Histological Analysis of Esophageal Organoids Modeling the Progression from Normal to Cancerous Tissues
Published on: May 30, 2025
Texture analysis of CT imaging for assessment of esophageal squamous cancer aggressiveness
Song Liu1, Huanhuan Zheng1, Xia Pan1
1Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China.
Background:
To explore the role of texture analysis of computed tomography (CT) images in preoperative assessment of esophageal squamous cell carcinoma (ESCC) aggressiveness.
Methods:
Seventy-three patients with pathologically confirmed ESCC underwent unenhanced and contrast enhanced CT imaging preoperatively. Texture analysis was performed on unenhanced and contrast enhanced CT images, respectively. Six CT texture parameters were obtained. One-way analysis of variance or independent-samples t-test (normality), independent-samples Kruskal-Wallis test or Mann-Whitney U test (non-normality), binary Logistic regression analysis (multivariable), Spearman correlation test, receiver operating characteristic (ROC) curve analysis and intraclass correlation coefficient (ICC) were used for statistical analyses.
Results:
Kurtosis was an independent predictor for T stages (T1-2 vs. T3-4) as well as overall stages (I-II vs. III-IV) based on unenhanced CT images, while entropy was an independent predictor for T stages (T1-2 vs. T3-4), lymph node metastasis (N- vs. N+) and overall stages (I/II vs. III/IV). Skew and kurtosis based on unenhanced CT images showed significant differences among N stages (N0, N1, N2 and N3) as well as 90th percentile based on contrast enhanced CT images. In correlation with T stage of ESCC, kurtosis and entropy significantly correlated with T stage both on unenhanced and contrast enhanced CT images. Reversely, entropy and 90th percentile based on contrast enhanced CT images showed significant correlations with N stage (r: 0.526, 0.265; both P<0.05), as well as overall stage (r: 0.562, 0.315; both P<0.05). For identifying ESCC with different T stages (T1-2 vs. T3-4), lymph node metastasis (N- vs. N+) and overall stages (I/II vs. III/IV), entropy based on contrast enhanced CT images, showed good performance with area under ROC curve area under curve (AUC) of 0.637, 0.815 and 0.778, respectively.
Conclusions:
Texture analysis of CT images held great potential in differentiating different T, N and overall stages of ESCC preoperatively, while failed to assess the differentiation degrees.
