Whole liver CT texture analysis to predict the development of colorectal liver metastases—A multicentre study

Objectives CT texture analysis has shown promise to differentiate colorectal cancer patients with/without hepatic metastases. Aim To investigate whether whole-liver CT texture analysis can also predict the development of colorectal liver metastases. Material and methods Retrospective multicentre study (n = 165). Three subgroups were assessed: patients [A] without metastases (n = 57), [B] with synchronous metastases (n = 54) and [C] who developed metastases within ≤24 months (n = 54). Whole-liver texture analysis was performed on primary staging CT. Mean grey-level intensity, entropy and uniformity were derived with different filters (σ0.5–2.5). Univariable logistic regression (group A vs. B) identified potentially predictive parameters, which were tested in multivariable analyses to predict development of metastases (group A vs. C), including subgroup analyses for early (≤6 months), intermediate (7–12 months) and late (13–24 months) metastases. Results Univariable analysis identified uniformity (σ0.5), sex, tumour site, nodal stage and carcinoembryonic antigen as potential predictors. Uniformity remained a significant predictor in multivariable analysis to predict early metastases (OR 0.56). None of the parameters could predict intermediate/late metastases. Conclusions Whole-liver CT-texture analysis has potential to predict patients at risk of developing early liver metastases ≤6 months, but is not robust enough to identify patients at risk of developing metastases at later stage.

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