Skip to main content
Erschienen in: Annals of Surgical Oncology 10/2020

18.05.2020 | Urologic Oncology

Development and External Validation of Radiomics Approach for Nuclear Grading in Clear Cell Renal Cell Carcinoma

verfasst von: Hongyu Zhou, MS, Haixia Mao, MD, Di Dong, PhD, Mengjie Fang, MS, Dongsheng Gu, MS, Xueling Liu, MD, Min Xu, MD, Shudong Yang, MD, Jian Zou, PhD, Ruohan Yin, MD, Hairong Zheng, PhD, Jie Tian, PhD, Changjie Pan, MD, Xiangming Fang, MD

Erschienen in: Annals of Surgical Oncology | Ausgabe 10/2020

Einloggen, um Zugang zu erhalten

Abstract

Background and Purpose

Nuclear grades of clear cell renal cell carcinoma (ccRCC) are usually confirmed by invasive methods. Radiomics is a quantitative tool that uses non-invasive medical imaging for tumor diagnosis and prognosis. In this study, a radiomics approach was proposed to analyze the association between preoperative computed tomography (CT) images and nuclear grades of ccRCC.

Methods

Our dataset included 320 ccRCC patients from two centers and was divided into a training set (n = 124), an internal test set (n = 123), and an external test set (n = 73). A radiomic feature set was extracted from unenhanced, corticomedullary phase, and nephrographic phase CT images. The maximizing independent classification information criteria function and recursive feature elimination with cross-validation were used to select effective features. Random forests were used to build a final model for predicting nuclear grades, and area under the receiver operating characteristic curve (AUC) was used to evaluate the performance of radiomic features and models.

Results

The radiomic features from the three CT phases could effectively distinguished the four nuclear grades. A combined model, merging radiomic features and clinical characteristics, obtained good predictive performances in the internal test set (AUC 0.77, 0.75, 0.79, and 0.85 for the four grades, respectively), and performance was further confirmed in the external test set, with AUCs of 0.75, 0.68, and 0.73 (no fourth-level data).

Conclusion

The combination of CT radiomic features and clinical characteristics could discriminate the nuclear grades in ccRCC, which may help in assisting treatment decision making.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Bhatt JR, Finelli A. Landmarks in the diagnosis and treatment of renal cell carcinoma. Nat Rev Urol. 2014;11:517–25.CrossRef Bhatt JR, Finelli A. Landmarks in the diagnosis and treatment of renal cell carcinoma. Nat Rev Urol. 2014;11:517–25.CrossRef
2.
Zurück zum Zitat Störkel S, Eble JN, Adlakha MD, et al. Classification of renal cell carcinoma. Cancer. 1997;80:987.CrossRef Störkel S, Eble JN, Adlakha MD, et al. Classification of renal cell carcinoma. Cancer. 1997;80:987.CrossRef
3.
Zurück zum Zitat Rabjerg M. Identification and validation of novel prognostic markers in Renal Cell Carcinoma. Dan Med J. 2017;64:B5339.PubMed Rabjerg M. Identification and validation of novel prognostic markers in Renal Cell Carcinoma. Dan Med J. 2017;64:B5339.PubMed
4.
Zurück zum Zitat Moch H, Cubilla AL, Humphrey PA, et al. The 2016 WHO classification of tumours of the urinary system and male genital organs—part A: renal, penile, and testicular tumours. Histopathology. 2016;46:93–105. Moch H, Cubilla AL, Humphrey PA, et al. The 2016 WHO classification of tumours of the urinary system and male genital organs—part A: renal, penile, and testicular tumours. Histopathology. 2016;46:93–105.
5.
Zurück zum Zitat Patard JJ, Leray E, Rioux-Leclercq N, et al. Prognostic value of histologic subtypes in renal cell carcinoma: a multicenter experience. J Urol. 2006;175:2763–71. Patard JJ, Leray E, Rioux-Leclercq N, et al. Prognostic value of histologic subtypes in renal cell carcinoma: a multicenter experience. J Urol. 2006;175:2763–71.
6.
Zurück zum Zitat Ljungberg B, Bensalah K, Canfield S, et al. EAU guidelines on renal cell carcinoma: 2014 update. Eur Urol. 2015;67:913–24.CrossRef Ljungberg B, Bensalah K, Canfield S, et al. EAU guidelines on renal cell carcinoma: 2014 update. Eur Urol. 2015;67:913–24.CrossRef
7.
Zurück zum Zitat Zhu YH, Wang X, Zhang J, et al. Low enhancement on multiphase contrast-enhanced CT images: an independent predictor of the presence of high tumor grade of clear cell renal cell carcinoma. AJR Am J Roentgenol. 2014;203:295–300.CrossRef Zhu YH, Wang X, Zhang J, et al. Low enhancement on multiphase contrast-enhanced CT images: an independent predictor of the presence of high tumor grade of clear cell renal cell carcinoma. AJR Am J Roentgenol. 2014;203:295–300.CrossRef
8.
Zurück zum Zitat Coy H, Douek M, Young J, et al. Differentiation of low grade from high grade clear cell renal cell carcinoma neoplasms using a CAD algorithm on four-phase CT. J Clin Oncol. 2016;34(15 Suppl):4564.CrossRef Coy H, Douek M, Young J, et al. Differentiation of low grade from high grade clear cell renal cell carcinoma neoplasms using a CAD algorithm on four-phase CT. J Clin Oncol. 2016;34(15 Suppl):4564.CrossRef
9.
Zurück zum Zitat Leibovich BC, Blute ML, Cheville JC, et al. Prediction of progression after radical nephrectomy for patients with clear cell renal cell carcinoma: a stratification tool for prospective clinical trials. Cancer. 2003;97:1663–71.CrossRef Leibovich BC, Blute ML, Cheville JC, et al. Prediction of progression after radical nephrectomy for patients with clear cell renal cell carcinoma: a stratification tool for prospective clinical trials. Cancer. 2003;97:1663–71.CrossRef
10.
Zurück zum Zitat Erdoğan F, et al. Prognostic significance of morphologic parameters in renal cell carcinoma. Am J Surg Pathol. 1982;58:655–63. Erdoğan F, et al. Prognostic significance of morphologic parameters in renal cell carcinoma. Am J Surg Pathol. 1982;58:655–63.
11.
Zurück zum Zitat Bretheau D, Lechevallier E, De FM, et al. Prognostic value of nuclear grade of renal cell carcinoma. Cancer. 1995;76:2543.CrossRef Bretheau D, Lechevallier E, De FM, et al. Prognostic value of nuclear grade of renal cell carcinoma. Cancer. 1995;76:2543.CrossRef
12.
Zurück zum Zitat Sekar RR, Patil D, Pearl J, et al. The relationship between preoperative c-reactive protein and Fuhrman nuclear grade in stage T1 renal cell carcinoma. J Urol. 2016;195:e1033.CrossRef Sekar RR, Patil D, Pearl J, et al. The relationship between preoperative c-reactive protein and Fuhrman nuclear grade in stage T1 renal cell carcinoma. J Urol. 2016;195:e1033.CrossRef
13.
Zurück zum Zitat Lambin P, Rios-Velazquez E, Leijenaar R, et al. Radiomics: extracting more information from medical images using advanced feature analysis. Eur J Cancer. 2012;48:441–6.CrossRef Lambin P, Rios-Velazquez E, Leijenaar R, et al. Radiomics: extracting more information from medical images using advanced feature analysis. Eur J Cancer. 2012;48:441–6.CrossRef
14.
Zurück zum Zitat Zhou H, Dong D, Chen B, et al. Diagnosis of distant metastasis of lung cancer: based on clinical and radiomic features. Transl Oncol. 2018;11:31–6.CrossRef Zhou H, Dong D, Chen B, et al. Diagnosis of distant metastasis of lung cancer: based on clinical and radiomic features. Transl Oncol. 2018;11:31–6.CrossRef
15.
Zurück zum Zitat Song J, Shi J, Dong D, et al. A new approach to predict progression-free survival in stage IV EGFR-mutant NSCLC patients with EGFR-TKI therapy. Clin Cancer Res. 2018;24(15):3583–92.CrossRef Song J, Shi J, Dong D, et al. A new approach to predict progression-free survival in stage IV EGFR-mutant NSCLC patients with EGFR-TKI therapy. Clin Cancer Res. 2018;24(15):3583–92.CrossRef
16.
Zurück zum Zitat Dong D, Tang L, Li Z-Y, et al. Development and validation of an individualized nomogram to identify occult peritoneal metastasis in patients with advanced gastric cancer. Ann Oncol. 2019;30:431–8.CrossRef Dong D, Tang L, Li Z-Y, et al. Development and validation of an individualized nomogram to identify occult peritoneal metastasis in patients with advanced gastric cancer. Ann Oncol. 2019;30:431–8.CrossRef
17.
Zurück zum Zitat Dong D, Zhang F, Zhong L-Z, et al. Development and validation of a novel MR imaging predictor of response to induction chemotherapy in locoregionally advanced nasopharyngeal cancer: a randomized controlled trial substudy (NCT01245959). BMC Med. 2019;17(1):190.CrossRef Dong D, Zhang F, Zhong L-Z, et al. Development and validation of a novel MR imaging predictor of response to induction chemotherapy in locoregionally advanced nasopharyngeal cancer: a randomized controlled trial substudy (NCT01245959). BMC Med. 2019;17(1):190.CrossRef
18.
Zurück zum Zitat Peng H, Dong D, Fang M, et al. Prognostic value of deep learning PET/CT-based radiomics: potential role for future individual induction chemotherapy in advanced nasopharyngeal carcinoma. Clin Cancer Res. 2019;25(14):4271–9.CrossRef Peng H, Dong D, Fang M, et al. Prognostic value of deep learning PET/CT-based radiomics: potential role for future individual induction chemotherapy in advanced nasopharyngeal carcinoma. Clin Cancer Res. 2019;25(14):4271–9.CrossRef
19.
Zurück zum Zitat Zhu X, Dong D, Chen Z, et al. Radiomic signature as a diagnostic factor for histologic subtype classification of non-small cell lung cancer. Eur Radiol. 2018;28(7):2772–8.CrossRef Zhu X, Dong D, Chen Z, et al. Radiomic signature as a diagnostic factor for histologic subtype classification of non-small cell lung cancer. Eur Radiol. 2018;28(7):2772–8.CrossRef
20.
Zurück zum Zitat Yang L, Dong D, Fang M, et al. Can CT-based radiomics signature predict KRAS/NRAS/BRAF mutations in colorectal cancer? Eur Radiol. 2018;28(5):2058–67.CrossRef Yang L, Dong D, Fang M, et al. Can CT-based radiomics signature predict KRAS/NRAS/BRAF mutations in colorectal cancer? Eur Radiol. 2018;28(5):2058–67.CrossRef
21.
Zurück zum Zitat Wang S, Zhou M, Liu Z, et al. Central focused convolutional neural networks: developing a data-driven model for lung nodule segmentation. Med Image Anal. 2017;40:172–83.CrossRef Wang S, Zhou M, Liu Z, et al. Central focused convolutional neural networks: developing a data-driven model for lung nodule segmentation. Med Image Anal. 2017;40:172–83.CrossRef
22.
Zurück zum Zitat Edge SB, Byrd DR, Compton CC, et al. American Joint Committee on Cancer (AJCC) cancer staging manual; 2010. Edge SB, Byrd DR, Compton CC, et al. American Joint Committee on Cancer (AJCC) cancer staging manual; 2010.
23.
Zurück zum Zitat Rios VE, Parmar C, Liu Y, et al. Somatic mutations drive distinct imaging phenotypes in lung cancer. Cancer Res. 2017;77:3922.CrossRef Rios VE, Parmar C, Liu Y, et al. Somatic mutations drive distinct imaging phenotypes in lung cancer. Cancer Res. 2017;77:3922.CrossRef
24.
Zurück zum Zitat Aerts HJWL, Velazquez ER, Leijenaar RTH, et al. Decoding tumour phenotype by noninvasive imaging using a quantitative radiomics approach. Nat Commun. 2014;5:4006.CrossRef Aerts HJWL, Velazquez ER, Leijenaar RTH, et al. Decoding tumour phenotype by noninvasive imaging using a quantitative radiomics approach. Nat Commun. 2014;5:4006.CrossRef
25.
Zurück zum Zitat Lambin P, Rth L, Deist TM, et al. Radiomics: the bridge between medical imaging and personalized medicine. Nat Rev Clin Oncol. 2017;14:749.CrossRef Lambin P, Rth L, Deist TM, et al. Radiomics: the bridge between medical imaging and personalized medicine. Nat Rev Clin Oncol. 2017;14:749.CrossRef
26.
Zurück zum Zitat Wang J, Wei JM, Yang Z, Wang SQ. Feature selection by maximizing independent classification information. IEEE Trans Knowl Data Eng. 2017;29:828–41.CrossRef Wang J, Wei JM, Yang Z, Wang SQ. Feature selection by maximizing independent classification information. IEEE Trans Knowl Data Eng. 2017;29:828–41.CrossRef
27.
Zurück zum Zitat Granitto PM, Furlanello C, Biasioli F, Gasperi F. Recursive feature elimination with random forest for PTR-MS analysis of agroindustrial products. Chemom Intell Lab Syst. 2006;83:83–90.CrossRef Granitto PM, Furlanello C, Biasioli F, Gasperi F. Recursive feature elimination with random forest for PTR-MS analysis of agroindustrial products. Chemom Intell Lab Syst. 2006;83:83–90.CrossRef
28.
Zurück zum Zitat Buitinck L, Louppe G, Blondel M, et al. API design for machine learning software: experiences from the scikit-learn project. Eprint Arxiv; 2013. Buitinck L, Louppe G, Blondel M, et al. API design for machine learning software: experiences from the scikit-learn project. Eprint Arxiv; 2013.
29.
Zurück zum Zitat Pedregosa F, Gramfort A, Michel V, et al. Scikit-learn: machine learning in python. J Mach Learn Res. 2016;12:2825–30. Pedregosa F, Gramfort A, Michel V, et al. Scikit-learn: machine learning in python. J Mach Learn Res. 2016;12:2825–30.
30.
Zurück zum Zitat Ding J, Xing Z, Jiang Z, et al. CT-based radiomic model predicts high grade of clear cell renal cell carcinoma. Eur J Radiol. 2018;103:51–6.CrossRef Ding J, Xing Z, Jiang Z, et al. CT-based radiomic model predicts high grade of clear cell renal cell carcinoma. Eur J Radiol. 2018;103:51–6.CrossRef
Metadaten
Titel
Development and External Validation of Radiomics Approach for Nuclear Grading in Clear Cell Renal Cell Carcinoma
verfasst von
Hongyu Zhou, MS
Haixia Mao, MD
Di Dong, PhD
Mengjie Fang, MS
Dongsheng Gu, MS
Xueling Liu, MD
Min Xu, MD
Shudong Yang, MD
Jian Zou, PhD
Ruohan Yin, MD
Hairong Zheng, PhD
Jie Tian, PhD
Changjie Pan, MD
Xiangming Fang, MD
Publikationsdatum
18.05.2020
Verlag
Springer International Publishing
Erschienen in
Annals of Surgical Oncology / Ausgabe 10/2020
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-020-08255-6

Weitere Artikel der Ausgabe 10/2020

Annals of Surgical Oncology 10/2020 Zur Ausgabe

Health Services Research and Global Oncology

Warm and Welcoming: Is It What We Say or How We Say It?

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

CME: 2 Punkte

Prof. Dr. med. Gregor Antoniadis Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

CME: 2 Punkte

Dr. med. Benjamin Meyknecht, PD Dr. med. Oliver Pieske Das Webinar S2e-Leitlinie „Distale Radiusfraktur“ beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

CME: 2 Punkte

Dr. med. Mihailo Andric
Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.