You have accessJournal of UrologyKidney Cancer: Epidemiology & Evaluation/Staging/Surveillance II (PD45)1 Apr 2020PD45-04 CLINICOPATHOLOGIC, LABORATORY, AND RADIOGRAPHIC INTEGRATED MACHINE LEARNING ALGORITHM FOR MALIGNANT RENAL MASSES Sagar Patel*, Caitlin Hensel, Jiaxian He, Rupali Bose, Charles Ellis, and Stephen Riggs Sagar Patel*Sagar Patel* More articles by this author , Caitlin HenselCaitlin Hensel More articles by this author , Jiaxian HeJiaxian He More articles by this author , Rupali BoseRupali Bose More articles by this author , Charles EllisCharles Ellis More articles by this author , and Stephen RiggsStephen Riggs More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000932.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: With pervasive abdominal imaging modalities, detection rates of incidental renal tumors have dramatic increased. The minority of clinicians utilize a holistic approach to work-up and educate patients about malignancy risk of newly diagnosed renal masses, subsequently limiting shared decision making, impairing transparency of recent clinical data, and ultimately, increasing nephrectomy utilization. To individualize renal mass diagnosis, we have evaluated clinicopathologic, laboratory, and radiographic parameters to develop a comprehensive machine learning approach to quantitate the likelihood of renal malignancy. METHODS: We retrospectively analyzed all nephrectomy patients from 2014-2019 using our prospectively maintained RedCap database from the electronic medical records. Demographic, clinical, and surgical pathology results were utilized. Individual components of nephrometry score was calculated at time of presentation using high-resolution abdominal imaging. Logistic regression models were developed to predict likelihood of malignant mass at presentation to our tertiary center, Levine Cancer Institute. For our unbalanced data distribution, ROC curves were used to determine cutoff values while balancing false positive (FPR) and false negative rates (FNR). For variables with less than 10% missing data, R package MICE was implemented. RESULTS: 1020 renal masses (99 benign, 921 malignant) were utilized to develop a machine learning algorithm. Benign nephrectomy specimen rate was 9.7%. Cohort was split into training (N = 765) and testing (N = 255) sets. Table 1 depicts input variables for predictive model. Based on the prediction calculated by logistic regression and the ROC metrics generated from the training data, an optimal cutoff of 0.89 was determined to maintain a 73% TPR and a 60% TNR in the test data. CONCLUSIONS: Using machine learning, we developed an integrated tool to quantify the preoperative likelihood of malignancy for new renal masses. Through optimization of our machine learning algorithm, 60% of true benign tumors (59 patients) would have evaded nephrectomies in our cohort. Model precision computations can improve understanding of renal cancer diagnosis, reduce healthcare cost, and decrease resource utilization. Source of Funding: NA © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e914-e914 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Sagar Patel* More articles by this author Caitlin Hensel More articles by this author Jiaxian He More articles by this author Rupali Bose More articles by this author Charles Ellis More articles by this author Stephen Riggs More articles by this author Expand All Advertisement PDF downloadLoading ...
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