Impact of MRI Texture Analysis on Complication Rate in MRI-Guided Liver Biopsies

Magnetic resonance imaging (MRI)-derived texture features are quantitative imaging parameters that may have valuable associations with clinical aspects. Their prognostic ability in patients undergoing percutaneous MRI-guided liver biopsy to identify associations with post-interventional bleeding complications and biopsy success rate has not been sufficiently investigated. The patient sample consisted 79 patients (32 females, 40.5%) with a mean age of 58.7 ± 12.4 years. Clinical parameters evaluated included comorbidities, pre-existing liver disease, known cancer diagnosis, and hemostaseological parameters. Several puncture-related parameters such as biopsy angle, distance of needle entry to capsule, and lesion were analyzed. MRI texture features of the target lesion were extracted from the planning sequence of the MRI-guided liver biopsy. Mann-Whitney U test and Fisher's exact test were used for group comparison; multivariate regression model was used for outcome prediction. Overall, the diagnostic outcome of biopsy was malignant in 38 cases (48.1%) and benign in 32 cases (40.5%). A total of 11 patients (13.9%) had post-interventional bleeding, while nine patients (11.4%) had a negative biopsy result. Several texture features were statistically significantly different between patients with and without hemorrhage. The texture feature GrVariance (1.37 ± 0.78 vs. 0.80 ± 0.35, p = 0.007) reached the highest statistical significance. Regarding unsuccessful biopsy results, S(1,1)DifEntrp (0.80 ± 0.10 vs. 0.89 ± 0.12, p = 0.022) and S(0,4)DifEntrp (1.14 ± 0.10 vs. 1.22 ± 0.11, p = 0.021) reached statistical significance between groups. Several MRI texture features of the target lesion were associated with bleeding complications or negative biopsy after MRI-guided percutaneous liver biopsy. This could be used to identify at-risk patients at the beginning of the procedure and should be further analyzed.