Application of computerized 3D-CT texture analysis of pancreas for the assessment of patients with diabetes

OBJECTIVE: To evaluate the role of computerized 3D CT texture analysis of the pancreas as quantitative parameters for assessing diabetes. METHODS: Among 2,493 patients with diabetes, 39 with type 2 diabetes (T2D) and 12 with type 1 diabetes (T1D) who underwent CT using two selected CT scanners, were enrolled. We compared these patients with age-, body mass index- (BMI), and CT scanner-matched normal subjects. Computerized texture analysis for entire pancreas was performed by extracting 17 variable features. A multivariate logistic regression analysis was performed to identify the predictive factors for diabetes. A receiver operator characteristic (ROC) curve was constructed to determine the optimal cut off values for statistically significant variables. RESULTS: In diabetes, mean attenuation, standard deviation, variance, entropy, homogeneity, surface area, sphericity, discrete compactness, gray-level co-occurrence matrix (GLCM) contrast, and GLCM entropy showed significant differences (P < .05). Multivariate analysis revealed that a higher variance (adjusted OR, 1.002; P = .005), sphericity (adjusted OR, 1.649x104; P = .048), GLCM entropy (adjusted OR, 1.057x105; P = .032), and lower GLCM contrast (adjusted OR, 0.997; P < .001) were significant variables. The mean AUCs for each feature were 0.654, 0.689, 0.620, and 0.613, respectively (P < .05). In subgroup analysis, only larger surface area (adjusted OR, 1.000; P = .025) was a significant predictor for T2D. CONCLUSIONS: Computerized 3D CT texture analysis of the pancreas could be helpful for predicting diabetes. A higher variance, sphericity, GLCM entropy, and a lower GLCM contrast were the significant predictors for diabetes.