Can Dual-Energy Computed Tomography Quantitative Analysis and Radiomics Differentiate Normal Liver From Hepatic Steatosis and Cirrhosis?

OBJECTIVES: This study aimed to assess if dual-energy computed tomography (DECT) quantitative analysis and radiomics can differentiate normal liver, hepatic steatosis, and cirrhosis. MATERIALS AND METHODS: Our retrospective study included 75 adult patients (mean age, 54 ± 16 years) who underwent contrast-enhanced, dual-source DECT of the abdomen. We used Dual-Energy Tumor Analysis prototype for semiautomatic liver segmentation and DECT and radiomic features. The data were analyzed with multiple logistic regression and random forest classifier to determine area under the curve (AUC). RESULTS: Iodine quantification (AUC, 0.95) and radiomic features (AUC, 0.97) differentiate between healthy and abnormal liver. Combined fat ratio percent and mean mixed CT values (AUC, 0.99) were the strongest differentiators of healthy and steatotic liver. The most accurate differentiating parameters of normal liver and cirrhosis were a combination of first-order statistics (90th percentile), gray-level run length matrix (short-run low gray-level emphasis), and gray-level size zone matrix (gray-level nonuniformity normalized; AUC, 0.99). CONCLUSION: Dual-energy computed tomography iodine quantification and radiomics accurately differentiate normal liver from steatosis and cirrhosis from single-section analyses.