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Juxtatumoral perinephric fat analysis in clear cell renal cell carcinoma

  • Kidneys, Ureters, Bladder, Retroperitoneum
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

The purpose of the study was to evaluate the feasibility of using contrast-enhanced computed tomography (CECT)-based texture analysis (CTTA) metrics to differentiate between juxtatumoral perinephric fat (JPF) surrounding low-grade (ISUP 1–2) versus high-grade (ISUP 3–4) clear cell renal cell carcinoma (ccRCC).

Methods

In this IRB-approved study, we retrospectively queried the surgical database between June 2009 and April 2016 and identified 83 patients with pathologically confirmed ccRCC (low grade: n = 54, mean age = 61.5 years, 18F/35M; high grade n = 30, mean age = 61.7 years, 8F/22M) who also had pre-operative multiphase CT acquisitions. CT images were transferred to a 3D workstation, and nephrographic phase JPF regions were manually segmented. Using an in-house developed Matlab program, a CTTA panel comprising of texture metrics extracted using six different methods, histogram, 2D- and 3D-Gray-level co-occurrence matrix (GLCM) and Gray-level difference matrix (GLDM), and 2D-Fast Fourier Transform (FFT) analyses, was applied to the segmented images to assess JPF textural heterogeneity in low- versus high-grade ccRCC. Univariate analysis and receiver-operator characteristics (ROC) analysis were used to assess interclass differences in texture metrics and their prediction accuracy, respectively.

Results

All methods except GLCM consistently revealed increased heterogeneity in the JPF surrounding high- versus low-grade ccRCC. FFT showed increased complexity index (p < 0.01). Histogram analysis showed increased kurtosis and positive skewness in (p < 0.03), and GLDM analysis showed decreased measure of correlation coefficient (MCC) (p < 0.04). Several of the GLCM metrics showed statistically significant (p < 0.04) textural differences between the two groups, but with no consistent trend. ROC analysis showed that MCC in GLCM analysis had an area under the curve of 0.75.

Conclusions

Our study suggests that CTTA of ccRCC shows statistically significant textural differences in JPF surrounding high- versus low-grade ccRCC.

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Acknowledgements

The authors acknowledge FUJIFILM Medical Systems USA, Inc. for the use of their Synapse® 3D software for completing this work.

Funding

The project did not receive any funding.

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Authors and Affiliations

  1. Keck School of Medicine, University of Southern California, Radiology, Los Angeles, CA, 90033, USA

    Tania S. Gill, Bino A. Varghese, Darryl H. Hwang, Steven Y. Cen & Vinay A. Duddalwar

  2. Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Pathology, Los Angeles, CA, USA

    Manju Aron

  3. Keck School of Medicine, USC Institute of Urology, University of Southern California, Los Angeles, CA, USA

    Monish Aron

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  1. Tania S. Gill
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  2. Bino A. Varghese
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Contributions

TG is the first author and drafted the manuscript. She manually segmented the JPF in Synapse 3D. BV performed data processing and reviewed manuscript. DH aided in CT analysis. SC performed the statistical analysis. MA performed pathological correlation. MA provided urological clinical significance. VD supervised the study, as well as reviewed and edited manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Vinay A. Duddalwar.

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Conflict of interest

Dr. Vinay Duddalwar serves as a consultant to Intuitive Surgical and as an advisor to DeepTek. Dr. Monish Aron serves as a consultant to Intuitive Surgical. The other authors have no conflict of interest with respect to the work presented in this manuscript.

Research involving human participants and/or animals

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Gill, T.S., Varghese, B.A., Hwang, D.H. et al. Juxtatumoral perinephric fat analysis in clear cell renal cell carcinoma. Abdom Radiol 44, 1470–1480 (2019). https://doi.org/10.1007/s00261-018-1848-x

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  • DOI: https://doi.org/10.1007/s00261-018-1848-x

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