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CT texture analysis in the differentiation of major renal cell carcinoma subtypes and correlation with Fuhrman grade

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Abstract

Objective

CT texture analysis (CTTA) using filtration-histogram–based parameters has been associated with tumor biologic correlates such as glucose metabolism, hypoxia, and tumor angiogenesis. We investigated the utility of these parameters for differentiation of clear cell from papillary renal cancers and prediction of Fuhrman grade.

Methods

A retrospective study was performed by applying CTTA to pretreatment contrast-enhanced CT scans in 290 patients with 298 histopathologically confirmed renal cell cancers of clear cell and papillary types. The largest cross section of the tumor on portal venous phase axial CT was chosen to draw a region of interest. CTTA comprised of an initial filtration step to extract features of different sizes (fine, medium, coarse spatial scales) followed by texture quantification using histogram analysis.

Results

A significant increase in entropy with fine and medium spatial filters was demonstrated in clear cell RCC (p = 0.047 and 0.033, respectively). Area under the ROC curve of entropy at fine and medium spatial filters was 0.804 and 0.841, respectively. An increased entropy value at coarse filter correlated with high Fuhrman grade tumors (p = 0.01). The other texture parameters were not found to be useful.

Conclusion

Entropy, which is a quantitative measure of heterogeneity, is increased in clear cell renal cancers. High entropy is also associated with high-grade renal cancers. This parameter may be considered as a supplementary marker when determining aggressiveness of therapy.

Key points

• CT texture analysis is easy to perform on contrast-enhanced CT.

• CT texture analysis may help to separate different types of renal cancers.

• CT texture analysis may enhance individualized treatment of renal cancers.

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Abbreviations

ccRCC:

Clear cell renal cell carcinoma

CTTA:

Computerized tomography (CT) texture analysis

pRCC:

Papillary renal cell carcinoma

RCC:

Renal cell carcinoma

ROC curve:

Receiver operating characteristic curve

SSF:

Spatial scaling factor associated with CTTA

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The authors state that this work has not received any funding.

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Authors and Affiliations

  1. Department of Radiology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China

    Yu Deng

  2. Department of Radiology, Indiana University School of Medicine, Indianapolis, IN, USA

    Yu Deng, Aster Samuel, Sakhi Shah, Enming Cui, Michael Asare-Sawiri & Kumaresan Sandrasegaran

  3. Department of Radiology, University of Florida College of Medicine, Jacksonville, FL, USA

    Erik Soule & Chandana Lall

  4. Department of Radiology, Jiangmen Central Hospital, Affiliated Jiangmen Hospital of Sun YAT-SEN University, Jiangmen, China

    Enming Cui

  5. Department of Oncology, Hope Regional Cancer Center, Panama, FL, USA

    Michael Asare-Sawiri

  6. Department of Urology, Indiana University School of Medicine, Indianapolis, IN, USA

    Chandru Sundaram

  7. Department of Radiology, Mayo Clinic, 5777 E. Mayo Blvd, Phoenix, AZ, 85054, USA

    Kumaresan Sandrasegaran

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  1. Yu Deng
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  3. Aster Samuel
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  9. Kumaresan Sandrasegaran
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Correspondence to Kumaresan Sandrasegaran.

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The scientific guarantor of this publication is Kumaresan Sandrasegaran, M.D.

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• Retrospective

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Deng, Y., Soule, E., Samuel, A. et al. CT texture analysis in the differentiation of major renal cell carcinoma subtypes and correlation with Fuhrman grade. Eur Radiol 29, 6922–6929 (2019). https://doi.org/10.1007/s00330-019-06260-2

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