Magnetic Resonance Imaging Radiomics Analyses for Prediction of High-Grade Histology and Necrosis in Clear Cell Renal Cell Carcinoma: Preliminary Experience.

Percutaneous renal mass biopsy results can accurately diagnose clear cell renal cell carcinoma (ccRCC); however, their reliability to determine nuclear grade in larger, heterogeneous tumors is limited. We assessed the ability of radiomics analyses of magnetic resonance imaging (MRI) to predict high-grade (HG) histology in ccRCC.

Seventy patients with a renal mass underwent 3 T MRI before surgery between August 2012 and August 2017. Tumor length, first-order statistics, and Haralick texture features were calculated on T2-weighted and dynamic contrast-enhanced (DCE) MRI after manual tumor segmentation. After a variable clustering algorithm was applied, tumor length, washout, and all cluster features were evaluated univariably by receiver operating characteristic curves. Three logistic regression models were constructed to assess the predictability of HG ccRCC and then cross-validated.

At univariate analysis, area under the curve values of length, and DCE texture cluster 1 and cluster 3 for diagnosis of HG ccRCC were 0.7 (95% confidence interval [CI], 0.58-0.82, false discovery rate P = .008), 0.72 (95% CI, 0.59-0.84, false discovery rate P = .004), and 0.75 (95% CI, 0.63-0.87, false discovery rate P = .0009), respectively. At multivariable analysis, area under the curve for model 1 (tumor length only), model 2 (length + DCE clusters 3 and 4), and model 3 (DCE cluster 1 and 3) for diagnosis of HG ccRCC were 0.67 (95% CI, 0.54-0.79), 0.82 (95% CI, 0.71-0.92), and 0.81 (95% CI, 0.70-0.91), respectively.

Radiomics analysis of MRI images was superior to tumor size for the prediction of HG histology in ccRCC in our cohort.

Clinical genitourinary cancer. 2020 May 23 [Epub ahead of print]

Durgesh K Dwivedi, Yin Xi, Payal Kapur, Ananth J Madhuranthakam, Matthew A Lewis, Durga Udayakumar, Robert Rasmussen, Qing Yuan, Aditya Bagrodia, Vitaly Margulis, Michael Fulkerson, James Brugarolas, Jeffrey A Cadeddu, Ivan Pedrosa

Department of Radiology, UT Southwestern Medical Center, Dallas, TX., Department of Radiology, UT Southwestern Medical Center, Dallas, TX; Department of Clinical Science, UT Southwestern Medical Center, Dallas, TX., Department of Pathology, UT Southwestern Medical Center, Dallas, TX; Department of Urology, UT Southwestern Medical Center, Dallas, TX; Kidney Cancer Program, UT Southwestern Medical Center, Dallas, TX., Department of Radiology, UT Southwestern Medical Center, Dallas, TX; Kidney Cancer Program, UT Southwestern Medical Center, Dallas, TX; Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, TX., Department of Urology, UT Southwestern Medical Center, Dallas, TX; Kidney Cancer Program, UT Southwestern Medical Center, Dallas, TX., Kidney Cancer Program, UT Southwestern Medical Center, Dallas, TX; Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX., Department of Radiology, UT Southwestern Medical Center, Dallas, TX; Department of Urology, UT Southwestern Medical Center, Dallas, TX; Kidney Cancer Program, UT Southwestern Medical Center, Dallas, TX; Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, TX. Electronic address: .