MP09-15 RADIOMICS ANALYSIS USING DYNAMIC COMPUTED TOMOGRAPHY FOR PREOPERATIVE RISK ASSESSMENT IN UPPER URINARY TRACT UROTHELIAL CARCINOMA

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP09-15 RADIOMICS ANALYSIS USING DYNAMIC COMPUTED TOMOGRAPHY FOR PREOPERATIVE RISK ASSESSMENT IN UPPER URINARY TRACT UROTHELIAL CARCINOMA Hiroki Kaneko, Koichiro Kimura, Hajime Tanaka, Wei Chen, Kasumi Yoshitomi, Takahiko Soma, Masaki Kobayashi, Motohiro Fujiwara, Yuki Nakamura, Bo Fan, Yudai Ishikawa, Shohei Fukuda, Yuma Waseda, Soichiro Yoshida, Minato Yokoyama, and Yasuhisa Fujii Hiroki KanekoHiroki Kaneko More articles by this author , Koichiro KimuraKoichiro Kimura More articles by this author , Hajime TanakaHajime Tanaka More articles by this author , Wei ChenWei Chen More articles by this author , Kasumi YoshitomiKasumi Yoshitomi More articles by this author , Takahiko SomaTakahiko Soma More articles by this author , Masaki KobayashiMasaki Kobayashi More articles by this author , Motohiro FujiwaraMotohiro Fujiwara More articles by this author , Yuki NakamuraYuki Nakamura More articles by this author , Bo FanBo Fan More articles by this author , Yudai IshikawaYudai Ishikawa More articles by this author , Shohei FukudaShohei Fukuda More articles by this author , Yuma WasedaYuma Waseda More articles by this author , Soichiro YoshidaSoichiro Yoshida More articles by this author , Minato YokoyamaMinato Yokoyama More articles by this author , and Yasuhisa FujiiYasuhisa Fujii More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003224.15AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The prognosis of patients with upper tract urothelial cancer (UTUC) is generally poor. Although neoadjuvant treatment may improve the survival outcomes after surgery, further explorations are required to identify the patients at high risk for recurrence preoperatively. In this study, we investigate the utility of radiomics analysis using computed tomography (CT) for preoperative risk assessment in UTUC. METHODS: We analyzed 55 patients with UTUC who underwent radical surgery (approval # M2019-192). All the patients were required to have dynamic CT before surgery, on which the tumor was identified and evaluable. Radiomics analysis was performed on the corticomedullary phase images using LIFEx software. The tumor contour was manually outlined on axial slices, and the volume of interest (VOI) of the tumor was set in each case. Based on tumor segmentation, 124 radiomic features were extracted from each VOI, and important features for predicting metastatic recurrence were identified using Boruta algorithm. Prognostic impact of the radiomic features was assessed using multivariable analysis incorporating preoperative clinical variables. RESULTS: The tumor was located in renal pelvis and ureter in 32 (58%) and 23 (42%) patients, respectively. Clinical T stages were Ta-1/2/≥3 in 30 (55%)/15 (27%)/10 (18%) patients, respectively. Hydronephrosis was observed in 15 (27%). On the surgical specimen, 18 cases (33%) had pathological ≥T3. During the median follow-up of 33 months, 8 patients (15%) experienced metastatic recurrence. The Boruta algorithm identified INTENSITY.BASED_90thPercentile.HU (IB90P) as an important feature for metastatic recurrence (Figure 1). The receiver operating characteristic curve defined the cut-off value of IB90P as 64.5. In multivariable Cox-proportional hazard analysis, IB90P <64.5 (HR=9.9, p=0.002) and hydronephrosis (HR=7.1, p=0.02) were independent risk factors of metastatic recurrence. Two-year metastasis-free survival were 45% and 95% in the patients with IB90P <64.5 and ≥64.5, respectively (Figure 1). CONCLUSIONS: Radiomics analysis using preoperative CT identified an independent risk factor for metastatic recurrence. It may help the preoperative risk stratification and decision making in the management of patients with UTUC. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e111 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Hiroki Kaneko More articles by this author Koichiro Kimura More articles by this author Hajime Tanaka More articles by this author Wei Chen More articles by this author Kasumi Yoshitomi More articles by this author Takahiko Soma More articles by this author Masaki Kobayashi More articles by this author Motohiro Fujiwara More articles by this author Yuki Nakamura More articles by this author Bo Fan More articles by this author Yudai Ishikawa More articles by this author Shohei Fukuda More articles by this author Yuma Waseda More articles by this author Soichiro Yoshida More articles by this author Minato Yokoyama More articles by this author Yasuhisa Fujii More articles by this author Expand All Advertisement PDF downloadLoading ...