Histogram Analysis of Computed Tomography Images to Differentiate Lacrimal Lymphoma and Lacrimal Inflammatory Pseudotumor

Abstract

Abstract Background To investigate the value of the histogram analysis to identify between lacrimal lymphoma(LL) and lacrimal inflammatory pseudotumor(LIP). Methods CT images of 30 patients with LL and 43 patients with LIP were analyzed for imaging features and histogram parameters. Tumor morphology and histogram parameters of LL and LIP were compared. Receiver operating characteristic (ROC) analysis of area under the curve (AUC), sensitivity, and specificity were used to measure the differential diagnostic efficacy of these parameters. Results Compared those in LIP group，lesions in LL group were more bilateral and had clearer boundary (P= .036 and .000, respectively), while no significant difference of other CT features was found between groups(all P> .05). The variance of the LIP group were greater than that of the LL group, with statistically significant differences (P=.000). The mean, skewness, kurtosis, 1th, 10th, and 50th percentiles of the LL group were greater than those of the LIP group, with statistically significant differences (all P＜.05). Acceptable discrimination was detected between LL and LIP with mean, variance, skewness, kurtosis, 1th, 10th, and 50th percentiles alone (AUC =0.789, 0.825, 0.716, 0.762, 0.624, 0.719, and 0.666 respectively). The combination of these histogram parameters yielded excellent discrimination between LL and LIP(AUC = 0.961), with sensitivity and specificity values greater than 0.800. Conclusions Histogram analysis of CT images is feasible for differentiating LL from LIP. It can be used as a supplementary tool for differentiating the lacrimal tumors.