PD08-06 FULLY AUTOMATED TUMOR CONTACT SURFACE AREA PREDICTS POSTOPERATIVE IPSILATERAL GFR PRESERVATION FOLLOWING PARTIAL NEPHRECTOMY

Abstract

You have accessJournal of UrologyCME1 Apr 2023PD08-06 FULLY AUTOMATED TUMOR CONTACT SURFACE AREA PREDICTS POSTOPERATIVE IPSILATERAL GFR PRESERVATION FOLLOWING PARTIAL NEPHRECTOMY Andrew Wood, Nicholas Heller, Tarik Benidir, Nour Abdallah, Fabian Isensee, Resha Tejpaul, Chalairat Suk-Ouichai, Caleb Curry, Alex You, Erick Remer, Samuel Haywood, Robert Abouassaly, Steven Campbell, Nikolaos Papanikolopoulos, and Christopher Weight Andrew WoodAndrew Wood More articles by this author , Nicholas HellerNicholas Heller More articles by this author , Tarik BenidirTarik Benidir More articles by this author , Nour AbdallahNour Abdallah More articles by this author , Fabian IsenseeFabian Isensee More articles by this author , Resha TejpaulResha Tejpaul More articles by this author , Chalairat Suk-OuichaiChalairat Suk-Ouichai More articles by this author , Caleb CurryCaleb Curry More articles by this author , Alex YouAlex You More articles by this author , Erick RemerErick Remer More articles by this author , Samuel HaywoodSamuel Haywood More articles by this author , Robert AbouassalyRobert Abouassaly More articles by this author , Steven CampbellSteven Campbell More articles by this author , Nikolaos PapanikolopoulosNikolaos Papanikolopoulos More articles by this author , and Christopher WeightChristopher Weight More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003239.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Tumor Contact Surface Area (CSA) is an externally validated nephrometry scoring system that requires measurement of multiple dimensions of cross sectional imaging. Despite studies demonstrating its ability to predict glomerular filtration rate (GFR) following partial nephrectomy (PN), its implementation has been slowed by required time investment and interobserver variability. We sought to evaluate the utility of artificial intelligence (AI) generated CSA as compared to human-generated CSA in predicting post-PN GFR. METHODS: A total of 300 patients with preoperative computerized tomography with early arterial contrast phase were identified from a cohort of 544 consecutive patients undergoing surgical extirpation for suspected renal cancer. A deep neural network approach was used to automatically segment kidneys and tumors, and then programed to generate the measurements and calculate tumor CSA. Human CSA scores were independently calculated by medical personnel blinded to AI-scores. Ipsilateral GFR before and after surgery was calculated from volumetric analyses of kidney parenchyma and pre and post-operative GFR values. AI-CSA and Human-CSA were then compared with regards to their ability to predict Ipsilateral GFR preservation. RESULTS: After removal of patients undergoing RN and those without requisite data for GFR calculation, a total of 150 patients were included in the analysis. There was significant agreement between Human CSA and AI-CSA on linear regression analysis (R2=0.74, p<0.0001). On univariate linear regression analysis, both AI- (r=0.217, p=0.0076) and Human generated (r=0.187, p=0.021) CSA similarly predicted ipsilateral GFR preservation. However, when incorporated into a MV model incorporating age, gender, body mass index, diabetes status, and ischemia time, only AI generated tumor CSA remained a significant predictor of ipsilateral GFR preservation (p=0.021). CONCLUSIONS: Fully automated tumor CSA calculations are not inferior, and may be superior, to human generated CSA calculations in predicting post-operative GFR after PN. Once validated, our results suggest that AI generated CSA could be delivered automatically from a preoperative CT scan to a clinician and patient at the point of care to aid in decision making. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e234 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Andrew Wood More articles by this author Nicholas Heller More articles by this author Tarik Benidir More articles by this author Nour Abdallah More articles by this author Fabian Isensee More articles by this author Resha Tejpaul More articles by this author Chalairat Suk-Ouichai More articles by this author Caleb Curry More articles by this author Alex You More articles by this author Erick Remer More articles by this author Samuel Haywood More articles by this author Robert Abouassaly More articles by this author Steven Campbell More articles by this author Nikolaos Papanikolopoulos More articles by this author Christopher Weight More articles by this author Expand All Advertisement PDF downloadLoading ...