Value of texture analysis based on contrast-enhanced CT images in assessing regional lymph node metastasis in patients with gastric cancer

Objective To investigate the value of texture analysis based on contrast-enhanced CT images in assessing regional lymph node metastasis in patients with gastric cancer. Methods Clinical data were collected from 174 patients with pathologically confirmed gastric cancer who underwent radical gastrectomy, and according to postoperative pathological results, the patients were divided into non-lymph node metastasis group with 49 patients and lymph node metastasis group with 125 patients. The CT Kinetics texture analysis software was used to extract 8 texture features (Mean value-A, Skewness-A, Kurtosis-A, Entropy-A, Mean value-V, Skewness-V, Kurtosis-V, and Entropy-V) of primary gastric cancer lesions, which were compared between the two groups. The receiver operating characteristic (ROC) curve were plotted to analyze the performance of CT texture features of primary gastric cancer lesions in assessing regional lymph node metastasis. Results There were significant differences in Entropy-A and Entropy-V of primary gastric cancer lesions between the lymph node metastasis group and the non-lymph node metastasis group (t=-5.592, -5.557,P0.05). Entropy-A and Entropy-V had an area under the ROC curve (AUC) of 0.751 and 0.754, respectively, in assessing regional lymph node metastasis in patients with gastric can-cer, with a cut-off value of 9.47 and 9.84, respectively, a sensitivity of 74.4% and 56.8%, respectively, and a specificity of 69.4% and 85.7%, respectively. Conclusion The texture analysis of primary gastric cancer lesions based on contrast-enhanced CT images has a certain value in assessing regional lymph node metastasis, and increases in the texture parameters Entropy-A and Entropy-V may indicate greater tumor heterogeneity and a higher probability of regional lymph node metastasis.