2025 Volume 72 Issue 3.4 Pages 367-374
Objectives:Malignant peripheral nerve sheath tumors (MPNSTs) are rare neoplasms requiring differentiation from benign neurogenic tumors on diagnostic imaging. We evaluated the diagnostic utility of texture analysis (TA) in distinguishing seven pathologically confirmed MPNSTs from eight schwannomas using magnetic resonance imaging (MRI), including T1- (T1WI) and T2-weighted imaging (T2WI), and apparent diffusion coefficient (ADC) maps. TA’s performance was compared with that of conventional approaches using ADC values alone. Methods:Tumors were segmented, and 90 texture features were extracted using LIFEx software. Significantly different features (p < 0.05) were identified using the Mann–Whitney U test and evaluated through receiver operating characteristic (ROC) analysis. ADC maps were used to measure the minimum, mean, and maximum ADC values, followed by ROC analysis. Results:Two T2WI-based texture features (neighborhood grey-tone difference matrix Contrast and grey-level size zone matrix Grey Level Variance) demonstrated the highest diagnostic performance (area under the curve = 0.911 [95% confidence interval (CI):0.755–1.000]), comparable to the minimum and mean ADC values (area under the curve = 0.898 [95% CI:0.691–1.000]). Conclusions:TA may help differentiate MPNSTs from schwannomas. T2WI-based TA offers a viable alternative when ADC maps are limited by magnetic susceptibility artifacts. J. Med. Invest. 72 : 367-374, August, 2025