Abstract
Background This study aimed to develop a prediction model to distinguish renal cell carcinoma (RCC) subtypes. Methods The radiomic features (RFs) from 5 different computed tomography (CT) phases were used in the prediction models: noncontrast phase (NCP), corticomedullary phase (CMP), nephrographic phase (NP), excretory phase (EP), and all-phase (ALL-P). Results For the ALL-P model, all of the RFs obtained from the 4 single-phase images were combined to 420 RFs. The ALL-P model performed the best of all models, with an accuracy of 0.80; the sensitivity and specificity for clear cell RCC (ccRCC) were 0.85 and 0.83; those for papillary RCC (pRCC) were 0.60 and 0.91; those for chromophobe RCC (cRCC) were 0.66 and 0.91, respectively. Binary classification experiments showed for distinguishing ccRCC vs. not-ccRCC that the area under the receiver operating characteristic curve (AUC) of the ALL-P and CMP models was 0.89, but the overall sensitivity/specificity/accuracy of the ALL-P model was better. For cRCC vs. non-cRCC, the ALL-P model had the best performance. Conclusions A reliable prediction model for RCC subtypes was constructed. The performance of the ALL-P prediction model was the best as compared to individual single-phase models and the traditional prediction model.
Highlights
Renal cell carcinoma (RCC) is one of the 10 most common malignant tumors in humans and the second most common malignant tumor of the urinary tract, accounting for about 3% of total cancers and 85% of malignant renal tumors [1]
Studies have shown that around 94% of patients with metastatic disease have clear cell RCC (ccRCC) with a 5-year survival rate of 44% to
Inclusion criteria were as follows: (1) diagnosis of RCC confirmed by histopathological examination of a tissue specimen by 2 pathologists; (2) good computed tomography (CT) image quality; (3) no treatment prior to the CT examination; and (4) CT performed with 4 phases: noncontrast phase (NCP), corticomedullary phase (CMP), nephrographic phase (NP), and excretory phase (EP)
Summary
Renal cell carcinoma (RCC) is one of the 10 most common malignant tumors in humans and the second most common malignant tumor of the urinary tract, accounting for about 3% of total cancers and 85% of malignant renal tumors [1]. Based on the 2016 World Health Organization (WHO) classification criteria, clear cell RCC (ccRCC), papillary RCC (pRCC), and chromophobe RCC (cRCC) account for 95% of all renal cancers and have a frequency of 75%, 15%, and 5%, respectively [2]. E biological behavior and aggressiveness of the different RCC subtypes are different and are treated differently and have a different prognosis [3]. Studies have shown that around 94% of patients with metastatic disease have ccRCC with a 5-year survival rate of 44% to. 69%, while the 5-year survival rate of type I pRCC and cRCC ranges from 78% to 92% [4, 5]. Less aggressive subtypes associated with a better prognosis are treated with a nephron-sparing partial nephrectomy and certain nonsurgical treatments [6]. Accurate identification of the RCC subtype is important for Journal of Oncology selecting the most appropriate treatment and improving outcomes
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