Gulcin ZENGIN, Tahsin AYBAL, Burcu OZDEMIR, Cigdem CELIKEL, Rabia ERGELEN
Marmara Medical Journal - 2026;39(2):92-101
Objective: To evaluate the diagnostic value of texture analysis in differentiating benign and malignant liver lesions, as well as distinguishing primary malignant liver tumors from metastases using pre-contrast magnetic resonance imaging (MRI) sequences. Materials and Methods: This retrospective study included 101 liver lesions from 100 patients who underwent upper abdominal MRI followed by biopsy or surgical resection. Texture analysis was performed on pre-contrast T1-weighted (T1W), T2-weighted (T2W), and apparent diffusion coefficient (ADC) sequences using first-order (histogram-based) and second-order (gray level co-occurrence matrix (GLCM)-based) statistical parameters. Group comparisons were conducted using Mann-Whitney U test, with a significance threshold of p < 0.05. Receiver operating characteristic (ROC) analysis was used to demonstrate the success of texture analysis parameters in distinguishing lesion subtypes. Results: Among 101 lesions, 90 were malignant and 11 were benign. Pre-contrast T1W, first-order parameters-mean, 50th, 90th, and 99th percentiles were significantly lower in malignant lesions compared to benign lesions. Primary malignant tumors and hepatocellular carcinoma (HCC) exhibited higher first-order values than metastatic lesions. Certain second-order parameters from pre-contrast T1W images also showed statistical significance, while ADC and T2W sequences revealed fewer differences. Conclusions: Texture analysis of pre-contrast MRI provides quantitative and objective evaluation of liver lesions, aiding differentiation between benign and malignant lesions and between primary and metastatic tumors. Pre-contrast T1W sequences were the most informative, highlighting the potential utility of texture analysis for patients unable to receive contrast agents.
