Enhanced staging of renal cell carcinoma using tumor morphology features: model development and multi-source validation

Abstract Preoperative detection of pT3a invasion in non-metastatic renal cell carcinoma (RCC) remains challenging with CT. This study developed and validated radiomic models using preoperative CT to identify pT3a invasions. Six models were trained and internally validated via nested cross-validation...

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Main Authors: Enyu Yuan, Yuntian Chen, Lei Ye, Ben He, ChunLei He, Junchao Ma, Ting Yang, Hao Zeng, Ling Yang, Jin Yao, Bin Song
Format: Article
Language:English
Published: Nature Portfolio 2025-05-01
Series:npj Digital Medicine
Online Access:https://doi.org/10.1038/s41746-025-01723-x
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author Enyu Yuan
Yuntian Chen
Lei Ye
Ben He
ChunLei He
Junchao Ma
Ting Yang
Hao Zeng
Ling Yang
Jin Yao
Bin Song
author_facet Enyu Yuan
Yuntian Chen
Lei Ye
Ben He
ChunLei He
Junchao Ma
Ting Yang
Hao Zeng
Ling Yang
Jin Yao
Bin Song
author_sort Enyu Yuan
collection DOAJ
description Abstract Preoperative detection of pT3a invasion in non-metastatic renal cell carcinoma (RCC) remains challenging with CT. This study developed and validated radiomic models using preoperative CT to identify pT3a invasions. Six models were trained and internally validated via nested cross-validation on 999 patients from one hospital. External validation included 313 patients from two hospitals and 204 patients from four TCIA datasets. A multi-reader multi-case study with seven radiologists evaluated the model’s incremental value. The morphology model achieved the highest internal AUC (0.867, 95% CI: 0.866–0.869) and maintained performance in external validations (AUC = 0.895 and 0.842). When used as a second reader, it significantly improved junior radiologists’ sensitivity and discrimination (AUC: 0.790 vs. 0.831, p < 0.001) without compromising specificity. This study demonstrates that CT-based radiomic models, particularly the morphology model, can reliably detect pT3a invasion and enhance diagnostic accuracy for junior radiologists, offering potential clinical utility in preoperative staging.
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issn 2398-6352
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publishDate 2025-05-01
publisher Nature Portfolio
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series npj Digital Medicine
spelling doaj-art-b1e9fb161c8d412ca189a0a9e36fd80d2025-08-20T01:53:19ZengNature Portfolionpj Digital Medicine2398-63522025-05-018111010.1038/s41746-025-01723-xEnhanced staging of renal cell carcinoma using tumor morphology features: model development and multi-source validationEnyu Yuan0Yuntian Chen1Lei Ye2Ben He3ChunLei He4Junchao Ma5Ting Yang6Hao Zeng7Ling Yang8Jin Yao9Bin Song10Department of Radiology, West China Hospital, Sichuan UniversityDepartment of Radiology, West China Hospital, Sichuan UniversityDepartment of Radiology, West China Hospital, Sichuan UniversityDepartment of Urology, The Third People’s Hospital of Chengdu/The Affiliated Hospital of Southwest Jiaotong UniversityDepartment of Radiology, West China Hospital, Sichuan UniversityDepartment of Radiology, West China Hospital, Sichuan UniversityDepartment of Radiology, West China Hospital, Sichuan UniversityDepartment of Urology, West China Hospital, Sichuan UniversityDepartment of Radiology, West China Hospital, Sichuan UniversityDepartment of Radiology, West China Hospital, Sichuan UniversityDepartment of Radiology, West China Hospital, Sichuan UniversityAbstract Preoperative detection of pT3a invasion in non-metastatic renal cell carcinoma (RCC) remains challenging with CT. This study developed and validated radiomic models using preoperative CT to identify pT3a invasions. Six models were trained and internally validated via nested cross-validation on 999 patients from one hospital. External validation included 313 patients from two hospitals and 204 patients from four TCIA datasets. A multi-reader multi-case study with seven radiologists evaluated the model’s incremental value. The morphology model achieved the highest internal AUC (0.867, 95% CI: 0.866–0.869) and maintained performance in external validations (AUC = 0.895 and 0.842). When used as a second reader, it significantly improved junior radiologists’ sensitivity and discrimination (AUC: 0.790 vs. 0.831, p < 0.001) without compromising specificity. This study demonstrates that CT-based radiomic models, particularly the morphology model, can reliably detect pT3a invasion and enhance diagnostic accuracy for junior radiologists, offering potential clinical utility in preoperative staging.https://doi.org/10.1038/s41746-025-01723-x
spellingShingle Enyu Yuan
Yuntian Chen
Lei Ye
Ben He
ChunLei He
Junchao Ma
Ting Yang
Hao Zeng
Ling Yang
Jin Yao
Bin Song
Enhanced staging of renal cell carcinoma using tumor morphology features: model development and multi-source validation
npj Digital Medicine
title Enhanced staging of renal cell carcinoma using tumor morphology features: model development and multi-source validation
title_full Enhanced staging of renal cell carcinoma using tumor morphology features: model development and multi-source validation
title_fullStr Enhanced staging of renal cell carcinoma using tumor morphology features: model development and multi-source validation
title_full_unstemmed Enhanced staging of renal cell carcinoma using tumor morphology features: model development and multi-source validation
title_short Enhanced staging of renal cell carcinoma using tumor morphology features: model development and multi-source validation
title_sort enhanced staging of renal cell carcinoma using tumor morphology features model development and multi source validation
url https://doi.org/10.1038/s41746-025-01723-x
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