Quantitative Analysis of Multiphase Contrast-Enhanced CT Images: A Pilot Study of Preoperative Prediction of Fat-Poor Angiomyolipoma and Renal Cell Carcinoma

Tang, Zhenchao; Yu, Dexin; Ni, Tianjiao; Zhao, Tongtong; Dong, Enqing

doi:10.2214/ajr.19.21625

Cited by 12 publications

(10 citation statements)

References 44 publications

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“…Occasionally, the subtle signal changes are not easily visible surrounding a tumor for radiologists, histogram features can provide more imaging details and assist doctors in diagnosis as a more sensitive quantitative approach (14,15,19,23). In this study, peri-mean was an independent predictor of MVI in both cohorts (sHCC and HCC >3 cm).…”

Section: Peri-stdmentioning

confidence: 54%

“…Histogram analysis is a useful and straightforward quantitative method that can be used to calculate the differentiation of pixel gray distribution and is helpful for radiologists to make a more objective diagnosis (14,15). Studies on HCC have shown that MR histogram analysis has progressed on diagnosis, biologic behavior, and therapy response prediction (16)(17)(18).…”

Section: Introductionmentioning

confidence: 99%

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Histogram peritumoral enhanced features on MRI arterial phase with extracellular contrast agent can improve prediction of microvascular invasion of hepatocellular carcinoma

Wang¹,

Sun²,

Zhou³

et al. 2022

Quant Imaging Med Surg

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Background: Preoperative microvascular invasion (MVI) prediction plays an important role in therapeutic decision-making of hepatocellular carcinoma (HCC). This study aimed to investigate the value of histogram based on the arterial phase (AP) of magnetic resonance imaging (MRI) with extracellular contrast agent compared with radiological features for predicting MVI of solitary HCC. Methods: In total, 113 patients with pathologically proven solitary HCC were retrospectively enrolled who received surgical resection and underwent preoperative abdominal MRI. The patients were divided into the ≤3 cm [small HCC (sHCC)] cohort and the >3 cm cohort. Based on pathological analysis of surgical specimens, the patients were classified into MVI negative (MVI−) and MVI positive (MVI+) groups. Peritumoral and intratumoral histogram features [mean, median, standard deviation (Std), coefficient of variation (CV), skewness, kurtosis] were acquired on AP subtraction images and radiological features [size, capsule, corona enhancement, corona enhancement thickness (CET), CET group]. Receiver operating characteristic (ROC) curve was constructed to assess predictive capability. Subgroup analysis of patients with a visible corona enhancement based on the CET cut-off value was performed.Results: None of the features extracted from the intratumor area were significantly different between the MVI+ and MVI− groups in both cohorts. Histogram defined peritumoral (peri-) mean, median, kurtosis, and radiological features including CET and CET group were associated with MVI in sHCCs. Peri-mean, median, Std and radiological features including incomplete capsule, CET, and CET group were associated with MVI in HCC >3 cm. In multivariate logistic regression analysis, the CET group and peri-mean were independent predictors for HCC >3 cm with an area under the curve (AUC) of 0.741. Peri-mean was an independent predictor for sHCC (AUC =0.798). Subgroup analysis of the corona enhancement using 8 mm as a cut-off value showed 100% sensitivity and negative predictive value (NPV).Conclusions: Peritumoral AP enhanced degree on MRI showed an encouraging predictive performance for preoperative prediction of MVI, especially in sHCCs. CET ≤8 mm could be used as a negative predictive marker for MVI.

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Section: Peri-stdmentioning

confidence: 54%

Section: Introductionmentioning

confidence: 99%

Histogram peritumoral enhanced features on MRI arterial phase with extracellular contrast agent can improve prediction of microvascular invasion of hepatocellular carcinoma

Wang¹,

Sun²,

Zhou³

et al. 2022

Quant Imaging Med Surg

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“…There is limited literature on the usefulness of computed tomography and magnetic resonance imaging in differentiating AML from other renal tumors, but recent studies show promising results for detecting lipid-poor AMLs and may play a role when contemplating active surveillance versus biopsy. [ 27 28 29 ] A large retrospective study on small AMLs[ 30 ] suggested that concerning features on ultrasound include irregular tumor borders, presence of calcification, extension beyond the renal capsule, and a size >4 cm. The slow annual growth rate of about 0.27 mm prompted these authors to suggest that subcentimeter asymptomatic AMLs, with no concerning ultrasound features, do not need further characterization or follow-up.…”

Section: Discussionmentioning

confidence: 99%

Adult renal angiomyolipomas: A retrospective analysis of the histological subtypes and their clinicoradiological correlates

et al. 2022

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Background: Renal angiomyolipomas (AMLs) are rare, benign mesenchymal tumors of the kidney. Asian data on the prevalence of the subtypes of AMLs and their association with tuberous sclerosis are sparse prompting us to evaluate the clinicopathological characteristics of these tumors. Materials and Methods: We included cases diagnosed from 2001 to 2021 extracting demographic details, clinical presentation, syndromic association with tuberous sclerosis, and preoperative clinicoradiological features from the electronic medical records. Results: Ninety-five cases of adult renal AML were diagnosed among 2402 renal tumors, a prevalence of 3.95%. Forty tumors (42%) were detected incidentally; two patients had life-threatening retroperitoneal hemorrhage. Tuberous sclerosis complex (TSC) was associated with ten cases (10.5%). These patients were a decade younger than those in the non-TSC group (P = 0.008) and had bilateral, multiple, and larger tumors (P = 0.0009, 0.001, and 0.047, respectively). Microscopically, classic and epithelioid subtypes were seen in 87 (91.6%) and 8 cases (8.4%), respectively. Hemorrhage was more common in the epithelioid subtype (P = 0.13). HMB-45, melan-A, and smooth muscle actin immunohistochemistry were useful in cases which lacked the prototypical classic histology and for confirming a diagnosis of epithelioid AML. Conclusions: The prevalence of renal AML in our series was four times higher, and the mean age at diagnosis was a decade earlier than that reported in Western literature but similar to data from two Asian countries. Similar studies from other countries will help ascertain if these differences in prevalence can be attributed to ethnic differences.

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“…Radiomics uses pixel-level quantitative parameters which are not apparent to the human eye, potentially predicting microscopic necrosis and tumor aggressiveness (7). Multiple studies have used TA to differentiate RCC from lpAML and oncocytoma on contrast-enhanced CT images (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23). MRI could potentially be superior to CT since it provides multiple paradigms for the morphological and functional assessment of renal tumors.…”

Section: B J R U N C O R R E C T E D P R O O F Smentioning

confidence: 99%

MR texture analysis in differentiating renal cell carcinoma from lipid-poor angiomyolipoma and oncocytoma

Razik

Goyal

Sharma

et al. 2020

The British Journal of Radiology

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Objectives: To assess the utility of Magnetic resonance texture analysis (MRTA) in differentiating renal cell carcinoma (RCC) from lipid-poor angiomyolipoma (lpAML) and oncocytoma. Methods: After ethical approval, 42 patients with 54 masses (34 RCC, 14 lpAML and six oncocytomas) who underwent MRI on a 1.5 T scanner (Avanto, Siemens, Erlangen, Germany) between January 2011 and December 2012 were retrospectively included in the study. MRTA was performed on the TexRAD research software (Feedback Plc., Cambridge, UK) using free-hand polygonal region of interest (ROI) drawn on the maximum cross-sectional area of the tumor to generate six first-order statistical parameters. The Mann-Whitney U test was used to look for any statically significant difference. The receiver operating characteristic (ROC) curve analysis was done to select the parameter with the highest class separation capacity [area under the curve (AUC)] for each MRI sequence. Results: Several texture parameters on MRI showed high class separation capacity (AUC > 0.8) in differentiating RCC from lpAML and oncocytoma. The best performing parameter in differentiating RCC from lpAML was mean of positive pixels (MPP) at SSF 2 (AUC: 0.891) on DWI b500. In differentiating RCC from oncocytoma, the best parameter was mean at SSF 0 (AUC: 0.935) on DWI b1000. Conclusions: MRTA could potentially serve as a useful non-invasive tool for differentiating RCC from lpAML and oncocytoma. Advances in knowledge: There is limited literature addressing the role of MRTA in differentiating RCC from lpAML and oncocytoma. Our study demonstrated several texture parameters which were useful in this regard.

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Quantitative Analysis of Multiphase Contrast-Enhanced CT Images: A Pilot Study of Preoperative Prediction of Fat-Poor Angiomyolipoma and Renal Cell Carcinoma

Cited by 12 publications

References 44 publications

Histogram peritumoral enhanced features on MRI arterial phase with extracellular contrast agent can improve prediction of microvascular invasion of hepatocellular carcinoma

Histogram peritumoral enhanced features on MRI arterial phase with extracellular contrast agent can improve prediction of microvascular invasion of hepatocellular carcinoma

Adult renal angiomyolipomas: A retrospective analysis of the histological subtypes and their clinicoradiological correlates

MR texture analysis in differentiating renal cell carcinoma from lipid-poor angiomyolipoma and oncocytoma

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