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

• Published in: Clinical genitourinary cancer 2021-02, Vol.19 (1), p.12-21.e1
• Main Authors: Dwivedi, Durgesh K., Xi, Yin, Kapur, Payal, Madhuranthakam, Ananth J., Lewis, Matthew A., Udayakumar, Durga, Rasmussen, Robert, Yuan, Qing, Bagrodia, Aditya, Margulis, Vitaly, Fulkerson, Michael, Brugarolas, James, Cadeddu, Jeffrey A., Pedrosa, Ivan
• Format: Article
• Language: English
• Subjects: Carcinoma, Renal Cell - diagnostic imaging; First-order statistics; Gray level co-occurrence matrix; Humans; Kidney cancer; Kidney Neoplasms - diagnostic imaging; Magnetic Resonance Imaging; Necrosis - diagnostic imaging; Reproducibility of Results; Retrospective Studies; Texture analysis; Tumor heterogeneity
• ISSN: 1558-7673; 1938-0682
• DOI: 10.1016/j.clgc.2020.05.011

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. Radiomics analyses including histogram data and Haralick texture features of magnetic resonance imaging (MRI) offer a reasonable and superior diagnostic performance compared to tumor size for the determination of tumor grade in patients with clear cell renal cell carcinoma (ccRCC). MRI-based radiomics may play an adjunct role to percutaneous renal biopsy in management decisions of ccRCC patients with heterogeneous tumors.