Radiomics-Based Preoperative Contrast Enhanced CT Histogram Analysis and Shape Feature Extraction in Laryngeal Squamous Cell Carcinoma: Correlation with Histopathological Parameters.

Aim: This study aims to investigate whether preoperative contrast-enhanced laryngeal CT-derived histogram parameters and shape features can correlate with cervical lymph node metastasis, tumor differentiation (grade), lymphovascular invasion, and perineural invasion in laryngeal squamous cell carcinoma (LSCC).

Materials and methods: Ninety-one patients who underwent laryngectomy and simultaneous cervical lymph node dissection at our hospital between 2015 and 2021, with LSCC as the final pathological outcome, were included. Two radiologists independently performed segmentation using 3D Slicer Software, drawing regions of interest (ROIs) from the widest axial section of each tumor and volumes of interest (VOIs) to cover the entire visualizable tumor. Histogram parameters and shape features were extracted for each segmentation. Cut-off values were calculated, and intraclass correlation was used to measure interobserver agreement.

Results: ROI measurements showed significant differences only for lymphovascular invasion. VOI measurements revealed significant differences between lymphovascular and perineural invasion and cervical lymph node metastasis. Key parameters included entropy, mean absolute deviation, and uniformity. No significant differences were found for tumor grade. VOI-based measurements outperformed ROI-based measurements in terms of reproducibility and diagnostic breadth, showing higher intraclass correlation values and more significant associations with pathological features.

Conclusion: Preoperative contrast-enhanced CT histogram parameters and shape features may be useful in evaluating tumor characteristics in LSCC.