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Fractal analysis of contrast-enhanced CT images for preoperative prediction of malignant potential of gastrointestinal stromal tumor

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Abstract

Purpose

The purpose of this study is to assess the heterogeneity of tumor enhancement using fractal analysis on contrast-enhanced computed tomography (CE-CT) for predicting malignant potential of gastrointestinal stromal tumor (GIST).

Methods

We retrospectively identified 64 patients (36 M/28 W; median age: 65) with GISTs who received CE-CT and 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) followed by curative surgery. Fractal analysis was applied to CE-CT image, and fractal dimension (FD) was measured. Diagnostic value of FD for malignant potential of GIST was compared with that of FDG-PET using the risk classification and Ki67 index.

Results

14 patients were categorized as the high risk, and 50 patients were as the very low, low or intermediate risk. FD of high-risk group was significantly higher than that of the other-risk group (p < 0.05). The areas under the ROC curves of FD and SUVmax for prediction of high-risk group were 0.82 and 0.93 (accuracy: 84.4% and 98.5%). FD showed a significant positive correlation with Ki67 index (p = 0.01).

Conclusion

Diagnostic value of CT fractal analysis for prediction of high-risk GIST is comparable with FDG-PET. In terms of cost and availability, fractal analysis has a potential to be an optimal preoperative biomarker.

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Authors and Affiliations

  1. Department of Frontier Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8677, Japan

    Yoshihiro Kurata, Koichi Hayano, Gaku Ohira, Kazuo Narushima, Tomoyoshi Aoyagi & Hisahiro Matsubara

Authors
  1. Yoshihiro Kurata
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  2. Koichi Hayano
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  3. Gaku Ohira
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  4. Kazuo Narushima
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  5. Tomoyoshi Aoyagi
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  6. Hisahiro Matsubara
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Corresponding author

Correspondence to Yoshihiro Kurata.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This retrospective study was approved by the institutional review board at our institute. Written informed consent for participation was not required because of the retrospective nature of this study; however, all patients gave their written informed consent to undergo CE-CT and FDG-PET examinations.

Informed consent

Informed consent for this study was waved by the hospital’s medical ethics committee as all patients underwent CT, MRI and FDG-PET as part of their clinical work-up.

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Kurata, Y., Hayano, K., Ohira, G. et al. Fractal analysis of contrast-enhanced CT images for preoperative prediction of malignant potential of gastrointestinal stromal tumor. Abdom Radiol 43, 2659–2664 (2018). https://doi.org/10.1007/s00261-018-1526-z

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  • DOI: https://doi.org/10.1007/s00261-018-1526-z

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