CT texture analysis of perihilar cholangiocarcinoma – associations with tumor grading, tumor markers and clinical outcome

Background: Texture analysis derived from computed tomography (CT) might be able to provide clinically relevant imaging biomarkers and might be associated with histopathology features in tumors. The present study sought to elucidate possible associations between texture features derived from CT images with grading, tumormarkers and survival in extrahepatic, perihilar cholangiocarcinomas tumors. Methods: 22 patients (n = 10 females; 45%, mean age of 71.8 ± 8.7 years) were included into this retrospective study. Texture analysis was performed using the free available Mazda software. All tumors were histopathologically confirmed. Results: In discrimination analysis, “S(1,1)SumVarnc” was statistically significantly different between patients with long-term survival and non long-term survival (mean 275.80 ± 32.57 vs. 239.65 ± 26.03, p = 0.01). The first-order parameter “Skewness” was associated with the tumormarker „Carcinoembryonic antigen “(CEA) (r=-0.66, p = 0.01). A statistically significant correlation of the texture parameter “S(5,0)SumVarnc” with tumor grading was identified (r=-0.587, p = 0.004). Several other texture features were correlated with the tumormarkers “Ca-19-9” and “AFP” and with T- and N-stadium of the tumors. Conclusion: Several texture features derived from CT were associated with tumor characteristics and survival in patients with perihilar cholangiocarcinomas. CT texture features could be used as valuable novel biomarkers in clinical routine.