Can contrast-enhancement computed tomography texture and histogram analyses help to differentiate malignant from...

We aimed to determine the ability of contrast-enhanced computed tomography (CECT) texture and histogram analyses to differentiate between benign and malignant thyroid nodules.

The clinical data from 49 patients with 60 thyroid nodules were retrospectively analyzed. Nodules were classified as malignant or benign based on their histological results. Five texture and histogram parameters of thyroid nodules from CECT images, including entropy, mean, standard deviation, skewness, and kurtosis, were compared and analyzed between the two groups. Regions of interest in axial CECT images were delineated manually by two radiologists. Interobserver agreement in texture and histogram parameters between the two radiologists was assessed using the intraclass correlation coefficient (ICC). The Mann-Whitney U test and receiver operating characteristic curve analysis were conducted to estimate the diagnostic capability of texture parameters.

Interobserver reproducibility (ICC = 0.919-0.969) was excellent. Among the 60 nodules, 36 were malignant and 24 were benign. Entropy of malignant thyroid nodules was significantly higher compared with benign thyroid nodules (P = 0.005). A trend toward a higher kurtosis value was observed in malignant thyroid nodules (P = 0.062). When an entropy value of 6.55 was used as a cutoff for differentiating benign from malignant thyroid nodules, the optimal area under the curve, sensitivity, and specificity were 0.716 (0.585-0.847, 95% confidence interval, P = 0.005), 75.0%, and 62.5%, respectively.

CECT texture and histogram analyses can be used to differentiate benign from malignant thyroid nodules.