Research paperWhole liver CT texture analysis to predict the development of colorectal liver metastases-A multicentre study

•Texture analysis may predict early colorectal liver metastases occurring ≤6 months.•Texture analysis may be a helpful adjunct to other clinical parameters.•Texture analysis cannot predict liver metastases occurring within 7-24 months.

ObjectivesCT texture analysis has shown promise to differentiate colorectal cancer patients with/without hepatic metastases.AimTo investigate whether whole-liver CT texture analysis can also predict the development of colorectal liver metastases.Material and methodsRetrospective multicentre study (n = 165). Three subgroups were assessed: patients [A] without metastases (n = 57), [B] with synchronous metastases (n = 54) and [C] who developed metastases within ≤24 months (n = 54). Whole-liver texture analysis was performed on primary staging CT. Mean grey-level intensity, entropy and uniformity were derived with different filters (σ0.5-2.5). Univariable logistic regression (group A vs. B) identified potentially predictive parameters, which were tested in multivariable analyses to predict development of metastases (group A vs. C), including subgroup analyses for early (≤6 months), intermediate (7-12 months) and late (13-24 months) metastases.ResultsUnivariable analysis identified uniformity (σ0.5), sex, tumour site, nodal stage and carcinoembryonic antigen as potential predictors. Uniformity remained a significant predictor in multivariable analysis to predict early metastases (OR 0.56). None of the parameters could predict intermediate/late metastases.ConclusionsWhole-liver CT-texture analysis has potential to predict patients at risk of developing early liver metastases ≤6 months, but is not robust enough to identify patients at risk of developing metastases at later stage.