Abstract
PurposeTo explore the value of CT-enhanced quantitative features combined with machine learning for differential diagnosis of renal chromophobe cell carcinoma (chRCC) and renal oncocytoma (RO).MethodsSixty-one cases of renal tumors (chRCC = 44; RO = 17) that were pathologically confirmed at our hospital between 2008 and 2018 were retrospectively analyzed. All patients had undergone preoperative enhanced CT scans including the corticomedullary (CMP), nephrographic (NP), and excretory phases (EP) of contrast enhancement. Volumes of interest (VOIs), including lesions on the images, were manually delineated using the RadCloud platform. A LASSO regression algorithm was used to screen the image features extracted from all VOIs. Five machine learning classifications were trained to distinguish chRCC from RO by using a fivefold cross-validation strategy. The performance of the classifier was mainly evaluated by areas under the receiver operating characteristic (ROC) curve and accuracy.ResultsIn total, 1029 features were extracted from CMP, NP, and EP. The LASSO regression algorithm was used to screen out the four, four, and six best features, respectively, and eight features were selected when CMP and NP were combined. All five classifiers had good diagnostic performance, with area under the curve (AUC) values greater than 0.850, and support vector machine (SVM) classifier showed a diagnostic accuracy of 0.945 (AUC 0.964 ± 0.054; sensitivity 0.999; specificity 0.800), showing the best performance.ConclusionsAccurate preoperative differential diagnosis of chRCC and RO can be facilitated by a combination of CT-enhanced quantitative features and machine learning.
Highlights
The incidence of renal cell carcinoma is increasing worldwide [1]
A total of 1029 image features were extracted from each phase of enhanced images of each patient
Renal oncocytoma (RO) is a benign tumor with good prognosis [5]
Summary
The incidence of renal cell carcinoma is increasing worldwide [1]. Chromophobe cell carcinoma (chRCC) of the kidney is second only to clear cell carcinoma of the kidney and papillary cell carcinoma of the kidney [1,2,3]. Renal oncocytoma (RO) is a benign renal tumor, accounting for about 3–7% of all renal tumors [4, 5]. Medical imaging plays an important role in the clinical management of renal tumors, such as detection of renal tumors, prediction of benign and malignant tumors, grading, and surgical treatment [6, 7]. Studies have shown that chRCC and RO overlap in morphological and immunological manifestations, and have similar imaging manifestations [8, 9]. Some researchers believe that a central scar is the characteristic of RO, its proportion is only about 33% [4, 6], but there are a few cases of chRCC with a central scar [8]
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