Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
GE Healthcare, Beijing, China.
Br J Radiol. 2023 Aug;96(1148):20221009. doi: 10.1259/bjr.20221009. Epub 2023 May 2.
We aimed to explore the diagnostic efficacy of MR texture analysis and imaging signs in the differentiation of renal oncocytoma from renal cell carcinoma (RCC).
From January 2015 to March 2019, a total of 168 localized solid renal masses (37 oncocytomas, 131 RCCs) were retrospectively included. Two radiologists reviewed complete MR images and recorded imaging presentation. Texture parameters were extracted from 3D ROIs on axial FSE-T2WI. Univariate and multivariate logistic regressions were used for feature selection and nomogram construction. The diagnostic performances were assessed by receiver operating characteristic (ROC) curves.
Cystic change, hemorrhage, SEI and four texture parameters significantly correlated with oncocytoma in the training cohort. For differentiating oncocytoma from RCC, the nomogram yielded an AUC of 0.874 in the training cohort and 0.830 in the testing cohort. For differentiating oncocytoma from chRCC, the nomogram had an AUC of 0.889 in the training cohort and 0.861 in the testing cohort. For differentiating oncocytoma from pRCC, the nomogram had an AUC of 0.932 in the training cohort and 0.792 in the testing cohort. For differentiating oncocytoma from ccRCC, the nomogram had an AUC of 0.829 in the training cohort and 0.813 in the testing cohort.
The diagnostic nomogram combining MR texture parameters with imaging signs performed well in differentiating oncocytomas with localized RCC and its subtypes.
Few articles reported using the combination of MR texture analysis with imaging signs in differentiating RCC from oncocytoma. Our study established a useful nomogram in subtype characterization.
本研究旨在探讨磁共振(MR)纹理分析和影像学征象在鉴别肾嗜酸细胞瘤(oncocytoma)与肾细胞癌(RCC)中的诊断效能。
回顾性纳入 2015 年 1 月至 2019 年 3 月间经手术病理证实的 168 例局限性肾占位性病变患者,包括 37 例肾嗜酸细胞瘤和 131 例 RCC。两名放射科医师分析所有患者的 MR 图像并记录影像学表现,于横轴位 FSE-T2WI 上勾画 3D 感兴趣区(ROI)并提取纹理参数。采用单因素和多因素逻辑回归进行特征筛选和列线图构建。采用受试者工作特征(ROC)曲线评估诊断效能。
在训练队列中,囊性变、出血、SEI 和 4 个纹理参数与肾嗜酸细胞瘤显著相关。列线图鉴别诊断肾嗜酸细胞瘤与 RCC 的曲线下面积(AUC)在训练队列和测试队列中分别为 0.874 和 0.830;鉴别肾嗜酸细胞瘤与透明细胞癌(chRCC)的 AUC 分别为 0.889 和 0.861;鉴别嗜酸细胞瘤与乳头状细胞癌(pRCC)的 AUC 分别为 0.932 和 0.792;鉴别嗜酸细胞瘤与嫌色细胞癌(ccRCC)的 AUC 分别为 0.829 和 0.813。
该列线图模型综合了 MR 纹理参数与影像学征象,可有效鉴别局限性 RCC 及其亚型。
目前鲜有文章报道联合应用 MR 纹理分析与影像学征象鉴别 RCC 与肾嗜酸细胞瘤,本研究建立了一种有助于区分 RCC 各亚型的列线图。