CT Texture Analysis of Adrenal Pheochromocytomas: a Pilot Study

Abstract: Since radiomics is a promising field of research, we tried to study the application of CT texture analysis in pheochromocytomas (PCCs) and the correlation between the features extracted and the secretory and histopathological data. 17 patients affected by surgically removed PCCs were retrospectively enrolled. Before surgery, all patients underwent contrast-enhanced CT. Patients had catecholamine secretion data available and Adrenal gland Scaled Score (PASS) of the histopathological examination. After a resampling of all CT images, the PCCs were delineated using the LifeX software in all three phases (unenhanced, arterial, and venous) and 58 texture parameters were extracted for each volume of interest. Through the Mann-Whitney test, the correlation between the hormonal hypersecretion, the malignancy score of the lesion (PASS>4), and texture parameters were studied. In the comparison between secreting and non-secreting catecholamine tumors the parameters DISCRETIZED_HUpeak e GLZLM_GLNU in the unenhanced phase and GLZLM_SZE, CONVENTIONAL_HUmean, CONVENTIONAL_HUQ3, DISCRETIZED_HUmean, DISCRETIZED_AUC_CSH, GLRLM_HGRE and GLZLM_SZHGE in the venous phase showed a statistically significant difference (p<0.01) while in the comparison between tumours with low and high PASS the parameters GLZLM_GLNU in unenhanced phase and GLRLM_GLNU e GLRLM_RLNU in the venous phase showed a statistically significant difference. CT texture analysis of pheochromocytomas can be a useful tool for the identification of malignant lesions and lesions that present hormonal hypersecretion.