CT attenuation-defined regional radiomics for liposarcoma subtype differentiation

CT attenuation-defined regional radiomics differentiated well-differentiated from dedifferentiated retroperitoneal liposarcoma with out-of-fold AUC 0.864 (95% CI 0.778-0.940) but did not significantly outperform quantitative CT (AUC 0.849; adjusted P=0.389).

• Retrospective cohort of 97 patients (57 well-differentiated and 40 dedifferentiated retroperitoneal liposarcomas) imaged with preoperative contrast-enhanced CT.
• Combining whole-tumor and fat-attenuation subregion features gave the highest regional radiomics AUC (0.864); adding soft-tissue or peritumoral features did not improve discrimination.
• The mean fold-wise AUC difference versus quantitative CT was 0.023 (95% CI -0.030 to 0.076; Holm-adjusted P=0.389); the clinical model AUC was 0.562. External validation is needed.

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