Center of Interventional Medicine, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong Province, China.
Center of Cerebrovascular Disease, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong Province, China.
Med Phys. 2024 Aug;51(8):5226-5235. doi: 10.1002/mp.17131. Epub 2024 May 27.
Accurate and noninvasive assessment of split renal dysfunction is crucial, while there is lack of corresponding method clinically.
To investigate the feasibility of using diffusion-weighted imaging (DWI)-based radiomics models to evaluate split renal dysfunction.
We enrolled patients with impaired and normal renal function undergoing renal DWI examination. Glomerular filtration rate (GFR, mL/min) was measured using 99mTc-DTPA scintigraphy, which is reference standard of GFR measurement. The kidneys were classified into normal (GFR ≥40), mildly impaired (20≤ GFR < 40), moderately impaired (10≤ GFR < 20), and severely impaired (GFR < 10) renal function groups. Optimized subsets of radiomics features were selected from renal DWI images and radiomics scores (Rad-score) calculated to discriminate groups with different renal function. The radiomics model (Rad-score based) was developed in a training cohort and validated in a test cohort. Evaluations were conducted on the discrimination, calibration, and clinical application of the method.
The final analysis included 330 kidneys. Logistic regression was used to develop three radiomics models, model A, B, and C, which were used to distinguish normal from impaired, mild from moderate, and moderate from severe renal function, respectively. The area under the curve of the three models were 0.822, 0.704, and 0.887 in the training cohort and 0.843, 0.717, and 0.897 in the test cohort, respectively, indicating efficient discrimination performance.
DWI-based radiomics models have potential for evaluating split renal dysfunction and discriminating between normal and impaired renal function groups and their subgroups.
准确且无创的分肾功能评估至关重要,但临床上缺乏相应的方法。
探讨基于扩散加权成像(DWI)的放射组学模型评估分肾功能的可行性。
我们纳入了接受肾脏 DWI 检查的肾功能受损和正常的患者。肾小球滤过率(GFR,mL/min)采用 99mTc-DTPA 闪烁显像法测量,该方法是 GFR 测量的参考标准。将肾脏分为正常(GFR≥40)、轻度受损(20≤GFR<40)、中度受损(10≤GFR<20)和重度受损(GFR<10)肾功能组。从肾脏 DWI 图像中选择优化的放射组学特征子集,并计算放射组学评分(Rad-score)以区分不同肾功能组。放射组学模型(基于 Rad-score)在训练队列中建立,并在测试队列中验证。评估方法的鉴别能力、校准能力和临床应用价值。
最终分析纳入 330 个肾脏。使用逻辑回归建立了三个放射组学模型,模型 A、B 和 C,分别用于区分正常与受损、轻度与中度、中度与重度肾功能。三个模型在训练队列中的曲线下面积分别为 0.822、0.704 和 0.887,在测试队列中的曲线下面积分别为 0.843、0.717 和 0.897,表明具有良好的鉴别性能。
基于 DWI 的放射组学模型具有评估分肾功能的潜力,并能区分正常和受损肾功能组及其亚组。