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To explore the value of contrast-enhanced CT texture analysis in predicting isocitrate dehydrogenase ( IDH ) mutation status of intrahepatic cholangiocarcinomas (ICCs). Institutional review board approved this study. Contrast-enhanced CT images of 138 ICC patients (21 with  IDH  mutation and 117 without  IDH  mutation) were retrospectively reviewed. Texture analysis was performed for each lesion and compared between ICCs with and without  IDH  mutation. All textural features in each phase and combinations of textural features (p < 0.05) by Mann–Whitney U tests were separately used to train multiple support vector machine (SVM) classifiers. The classification generalizability and performance were evaluated using a tenfold cross-validation scheme. Among plain, arterial phase (AP), portal venous phase (VP), equilibrium phase (EP) and Sig classifiers, VP classifier showed the highest accuracy of 0.863 (sensitivity, 0.727; specificity, 0.885), with a mean area under the receiver operating characteristic curve of 0.813 in predicting  IDH  mutation in validation cohort. Texture features of CT images in portal venous phase could predict  IDH  mutation status of ICCs with SVM classifier preoperatively.

Value of contrast-enhanced CT texture analysis in predicting IDH mutation status of intrahepatic cholangiocarcinoma