Abstract
Objective:To evaluate the value of 2-dimensional (2D) and 3-dimensional (3D) computed tomography texture analysis (CTTA) models in distinguishing fat-poor angiomyolipoma (fpAML) from chromophobe renal cell carcinoma (chRCC).Methods:We retrospectively enrolled 32 fpAMLs and 24 chRCCs. Texture features were extracted from 2D and 3D regions of interest in triphasic CT images. The 2D and 3D CTTA models were constructed with the least absolute shrinkage and selection operator algorithm and texture scores were calculated. The diagnostic performance of the 2D and 3D CTTA models was evaluated with respect to calibration, discrimination, and clinical usefulness.Results:Of the 177 and 183 texture features extracted from 2D and 3D regions of interest, respectively, 5 2D features and 8 3D features were selected to build 2D and 3D CTTA models. The 2D CTTA model (area under the curve [AUC], 0.811; 95% confidence interval [CI], 0.695-0.927) and the 3D CTTA model (AUC, 0.915; 95% CI, 0.838-0.993) showed good discrimination and calibration (P > .05). There was no significant difference in AUC between the 2 models (P = .093). Decision curve analysis showed the 3D model outperformed the 2D model in terms of clinical usefulness.Conclusions:The CTTA models based on contrast-enhanced CT images had a high value in differentiating fpAML from chRCC.
Highlights
Angiomyolipoma (AML) is the most common benign neoplasm of the kidney.[1]
A total of 24 chromophobe renal cell carcinoma (RCC) (chRCC) (13 males and 11 females; mean age, 52.88 + 10.86 years; age range, 24-72 years) and 32 fat-poor AML (fpAML) (8 males and 24 females; mean age, 50.38 + 8.66 years; age range, 34-67 years) were enrolled according to the following inclusion criteria: (1) patients with a pathologically confirmed single renal mass, either fpAML or chRCC, after radical or partial nephrectomy; (2) patients had undergone a 3-phase Computed tomography (CT) scan 2 weeks before receiving any treatment and/or surgery; (3) CT images were of diagnostic quality; (4) there was no visible fat inside the renal masses on CT scan in the fpAML group
Univariate analysis was used to compare the differences of age, gender, and Tex-score between fpAML and chRCC patients by using the w2 test or Fisher exact test for categoric variables and Mann-Whitney U test for continuous variables, where appropriate
Summary
Angiomyolipoma (AML) is the most common benign neoplasm of the kidney.[1] Most typical AMLs can be diagnosed on imaging by their mature fat components, which is a dependable method to distinguish AML from renal cell carcinoma (RCC). 5% of AMLs lack visible fat and mainly consist of blood vessels and smooth muscle cells; these are labeled as “fat-poor AML (fpAML)”.2. Renal cell carcinoma has been classified into 3 major histologic subtypes: clear cell RCC (65%*70%), papillary RCC (18.5%), and chromophobe RCC (chRCC; 5%*7%) by the 2016 World Health Organization.[3] Among the 3 subtypes, chRCC is the rarest and least studied. Malignant chRCC is usually treated with radical nephrectomy, while AML can be monitored without any treatment or can be removed with nephron-sparing surgery.[4] it is quite important to accurately distinguish fpAML from chRCC before surgery
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
