Focal splenic lesions: Imaging spectrum of diseases on CT, MRI and PET/CT

Barat, Maxime; Hoeffel, Christine; Aissaoui, Mathilde; Dohan, Anthony; Oudjit, Ammar; Dautry, Raphaël; Pathil, Anita; Malgras, Brice; Soyer, Philippe

doi:10.1016/j.diii.2021.03.006

Cited by 13 publications

(21 citation statements)

References 92 publications

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“…Secondly, the spleen is a parenchymatous organ surrounded by peri-splenic fat and therefore easy to automatically segment. Humpire-Mamani et al have shown that a neural network can be trained to segment the spleen in CT scans with an accuracy that is comparable to an experienced radiologist [34,35]. Such a performance would not be expected for involved lymph node sites, which can occur on any site within the scan volume.…”

Section: Discussionmentioning

confidence: 99%

Radiomics Features of the Spleen as Surrogates for CT-Based Lymphoma Diagnosis and Subtype Differentiation

Enke

Moltz

D’Anastasi

et al. 2022

Cancers

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The spleen is often involved in malignant lymphoma, which manifests on CT as either splenomegaly or focal, hypodense lymphoma lesions. This study aimed to investigate the diagnostic value of radiomics features of the spleen in classifying malignant lymphoma against non-lymphoma as well as the determination of malignant lymphoma subtypes in the case of disease presence—in particular Hodgkin lymphoma (HL), diffuse large B-cell lymphoma (DLBCL), mantle-cell lymphoma (MCL), and follicular lymphoma (FL). Spleen segmentations of 326 patients (139 female, median age 54.1 +/− 18.7 years) were generated and 1317 radiomics features per patient were extracted. For subtype classification, we created four different binary differentiation tasks and addressed them with a Random Forest classifier using 10-fold cross-validation. To detect the most relevant features, permutation importance was analyzed. Classifier results using all features were: malignant lymphoma vs. non-lymphoma AUC = 0.86 (p < 0.01); HL vs. NHL AUC = 0.75 (p < 0.01); DLBCL vs. other NHL AUC = 0.65 (p < 0.01); MCL vs. FL AUC = 0.67 (p < 0.01). Classifying malignant lymphoma vs. non-lymphoma was also possible using only shape features AUC = 0.77 (p < 0.01), with the most important feature being sphericity. Based on only shape features, a significant AUC could be achieved for all tasks, however, best results were achieved combining shape and textural features. This study demonstrates the value of splenic imaging and radiomic analysis in the diagnostic process in malignant lymphoma detection and subtype classification.

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Section: Discussionmentioning

confidence: 99%

Radiomics Features of the Spleen as Surrogates for CT-Based Lymphoma Diagnosis and Subtype Differentiation

Enke

Moltz

D’Anastasi

et al. 2022

Cancers

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Section: Discussionmentioning

confidence: 99%

“…In human medicine, FSL diagnosis based on diagnostic imaging findings alone poses challenges similar to those of the veterinary context ( 25 ). Nonetheless, the combination of CT, MRI and 18F-FDG PET/CT enables attainment of a high degree of confidence for lesion characterisation ( 25 ). However, due to the limited availability of such imaging devices and of properly developed techniques (18F-FDG PET/CT) in veterinary medicine, the MRI features of FSLs have seldom been described in dogs ( 26 ).…”

Section: Discussionmentioning

confidence: 99%

A Machine Learning-Based Approach for Classification of Focal Splenic Lesions Based on Their CT Features

et al. 2022

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The aim of the study was to describe the CT features of focal splenic lesions (FSLs) in dogs in order to predict lesion histotype. Dogs that underwent a CT scan and had a FSL diagnosis by cytology or histopathology were retrospectively included in the study. For the statistical analysis the cases were divided into four groups, based on the results of cytopatholoy or hystopathology, namely: nodular hyperplasia (NH), other benign lesions (OBLs), sarcoma (SA), round cell tumour (RCT). Several qualitative and quantitative CT features were described for each case. The relationship occurring between each individual CT feature and the histopathological groups was explred by means of c chi-square test for the count data and by means of Kruskal-Wallis or ANOVA for the continuous data. Furthermore, the main features of each group were described using factorial discriminant analysis, and a decision tree for lesion classification was then developed. Sarcomas were characterised by large dimensions, a cystic appearance and an overall low post contrast-enhancement. NH and OBLs were characterised by small dimensions, a solid appearance and a high post-contrast enhancement. OBLs showed higher post-contrast values than NH. Lastly, RCTs did not exhibit any distinctive CT features. The proposed decision tree had a high accuracy for the classification of SA (0.89) and a moderate accuracy for the classification of OBLs and NH (0.79), whereas it was unable to classify RCTs. The results of the factorial analysis and the proposed decision tree could help the clinician in classifying FSLs based on their CT features. A definitive FSL diagnosis can only be obtained by microscopic examination of the spleen.

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“…By analyzing the available relevant literature, it was indicated that IPT-like FDCS is more common in East Asia, accounting for 81.13% of worldwide cases, which may be due to the food culture (e.g., Chinese-style salted fish) and level of economic development in East Asian countries (12) (Table I). The imaging presentation was summarized based on previous reports in the literature (7,13). In most cases of IPT-like FDCS, the lesion appears on CT as a round, hypodense mass with well-defined borders, frequently with hemorrhage, necrosis and calcification.…”

Section: Discussionmentioning

confidence: 99%

“…The imaging presentation was summarized based on previous reports in the literature ( 7 , 13 ). In most cases of IPT-like FDCS, the lesion appears on CT as a round, hypodense mass with well-defined borders, frequently with hemorrhage, necrosis and calcification.…”

Section: Discussionmentioning

confidence: 99%

Imaging findings of inflammatory pseudotumor‑like follicular dendritic cell sarcoma of the spleen: A case report and literature review

Zhang

et al. 2022

Oncol Lett

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Inflammatory pseudotumor-like follicular dendritic cell sarcoma (IPT-like FDCS) is a low-grade malignant tumor type caused by the proliferation of follicular dendritic cells. It is a distinct subtype of FDCS that is rarely encountered in the clinic and is overwhelmingly associated with Epstein-Barr virus infection. As it is a sporadic disease with a low specificity of clinical and imaging manifestations, it is less frequently considered a diagnosis, resulting in a low preoperative diagnostic rate and easy misdiagnosis. The present study reported the ultrasound, CT and MRI features of a patient with splenic IPT-like FDCS and discussed this rare subtype of FDCS based on a review of previously published literature to provide radiologists with a broader understanding of the differential diagnosis of splenic lesions.

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Focal splenic lesions: Imaging spectrum of diseases on CT, MRI and PET/CT

Cited by 13 publications

References 92 publications

Radiomics Features of the Spleen as Surrogates for CT-Based Lymphoma Diagnosis and Subtype Differentiation

Radiomics Features of the Spleen as Surrogates for CT-Based Lymphoma Diagnosis and Subtype Differentiation

A Machine Learning-Based Approach for Classification of Focal Splenic Lesions Based on Their CT Features

Imaging findings of inflammatory pseudotumor‑like follicular dendritic cell sarcoma of the spleen: A case report and literature review

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