Feasibility of computed tomography texture analysis of hepatic fibrosis using dual-energy spectral detector computed tomography

Byuk Gyung Choi, In Young Choi, Sang Hoon Cha, Suk Keu Yeom, Hwan Hoon Chung, Seung Hwa Lee, Jaehyung Cha, Ju Han Lee

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)


Purpose: To evaluate feasibility of computer tomography texture analysis (CTTA) at different energy level using dual-energy spectral detector CT for liver fibrosis. Materials and methods: Eighty-seven patients who underwent a spectral CT examination and had a reference standard of liver fibrosis (histopathologic findings, n = 61, or clinical findings for normal, n = 26) were included. Mean gray-level intensity, mean number of positive pixels (MPP), entropy, skewness, and kurtosis using commercially available software (TexRAD) were compared at different energy levels. Optimal CTTA parameter cutoffs to diagnose liver fibrosis were evaluated. CTTA parameters at different energy levels correlated with liver fibrosis. The association of CTTA parameters with energy level was evaluated. Results: Mean gray-level intensity, skewness, kurtosis, and entropy showed significant differences between patients with and without clinically significant hepatic fibrosis (P < 0.05). Mean gray-level intensity at 50 keV was significantly positively correlated with liver fibrosis (ρ = 0.502, P < 0.001). To diagnose stages F2–F4, entropy and mean gray-level intensity at low keV level showed the largest area under the curve (AUC; 0.79 and 0.79). Estimated marginal means (EMMs) of mean gray-level intensity showed prominent differences at low energy levels. Conclusion: CTTA parameters from different keV levels demonstrated meaningful accuracy for diagnosis of liver fibrosis or clinically significant hepatic fibrosis.

Original languageEnglish
Pages (from-to)1179-1189
Number of pages11
JournalJapanese Journal of Radiology
Issue number12
Publication statusPublished - 2020 Dec
Externally publishedYes


  • Dual-energy spectral CT
  • Fibrosis
  • Liver
  • Quantitative imaging
  • Texture analysis

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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