Development of modified multi-parametric CT algorithms for diagnosing clear-cell renal cell carcinoma in small solid renal masses
Abstract Objective To refine the existing CT algorithm to enhance inter-reader agreement and improve the diagnostic performance for clear-cell renal cell carcinoma (ccRCC) in solid renal masses less than 4 cm. Methods A retrospective collection of 331 patients with pathologically confirmed renal mas...
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BMC
2025-02-01
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| Series: | Cancer Imaging |
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| Online Access: | https://doi.org/10.1186/s40644-025-00847-3 |
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| author | Pengfei Jin Linghui Zhang Hong Yang Tingting Jiang Chenyang Xu Jiehui Huang Zhongyu Zhang Lei Shi Xu Wang |
| author_facet | Pengfei Jin Linghui Zhang Hong Yang Tingting Jiang Chenyang Xu Jiehui Huang Zhongyu Zhang Lei Shi Xu Wang |
| author_sort | Pengfei Jin |
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| description | Abstract Objective To refine the existing CT algorithm to enhance inter-reader agreement and improve the diagnostic performance for clear-cell renal cell carcinoma (ccRCC) in solid renal masses less than 4 cm. Methods A retrospective collection of 331 patients with pathologically confirmed renal masses were enrolled in this study. Two radiologists independently assessed the CT images: in addition to heterogeneity score (HS) and mass-to-cortex corticomedullary attenuation ratio (MCAR), measured parameters included ratio of major diameter to minor diameter at the maximum axial section (Major axis / Minor axis), tumor-renal interface, standardized heterogeneity ratio (SHR), and standardized nephrographic reduction rate (SNRR). Spearman's correlation analysis was performed to evaluate the relationship between SHR and HS. Univariate and multivariate logistic regression analyses were employed to identify independent risk factors and then CT-score was adjusted by those indicators. The diagnostic efficacy of the modified CT-scores was evaluated using ROC curve analysis. Results The SHR and heterogeneity grade (HG) of mass were correlated positively with the HS (R = 0.749, 0.730, all P < 0.001). Logistic regression analysis determined that the Major axis / Minor axis (> 1.16), the tumor-renal interface (> 22.3 mm), and the SNRR (> 0.16) as additional independent risk factors to combine with HS and MCAR. Compared to the original CT-score, the two CT algorithms combined tumor-renal interface and SNRR showed significantly improved diagnostic efficacy for ccRCC (AUC: 0.770 vs. 0.861 and 0.862, all P < 0.001). The inter-observer agreement for HG was higher than that for HS (weighted Kappa coefficient: 0.797 vs. 0.722). The consistency of modified CT-score was also superior to original CT-score (weighted Kappa coefficient: 0.935 vs. 0.878). Conclusion The modified CT algorithms not only enhanced inter-reader consistency but also improved the diagnostic capability for ccRCC in small renal masses. |
| format | Article |
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| institution | OA Journals |
| issn | 1470-7330 |
| language | English |
| publishDate | 2025-02-01 |
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| series | Cancer Imaging |
| spelling | doaj-art-cf6966abb3204da19af2fb6ad6f52c452025-08-20T02:16:45ZengBMCCancer Imaging1470-73302025-02-0125111310.1186/s40644-025-00847-3Development of modified multi-parametric CT algorithms for diagnosing clear-cell renal cell carcinoma in small solid renal massesPengfei Jin0Linghui Zhang1Hong Yang2Tingting Jiang3Chenyang Xu4Jiehui Huang5Zhongyu Zhang6Lei Shi7Xu Wang8Department of Radiology, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of SciencesDepartment of Radiology, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of SciencesDepartment of Radiology, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of SciencesDepartment of Radiology, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of SciencesDepartment of Pathology, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of SciencesDepartment of Radiology, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of SciencesDepartment of Radiology, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of SciencesDepartment of Radiology, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of SciencesDepartment of Radiology, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of SciencesAbstract Objective To refine the existing CT algorithm to enhance inter-reader agreement and improve the diagnostic performance for clear-cell renal cell carcinoma (ccRCC) in solid renal masses less than 4 cm. Methods A retrospective collection of 331 patients with pathologically confirmed renal masses were enrolled in this study. Two radiologists independently assessed the CT images: in addition to heterogeneity score (HS) and mass-to-cortex corticomedullary attenuation ratio (MCAR), measured parameters included ratio of major diameter to minor diameter at the maximum axial section (Major axis / Minor axis), tumor-renal interface, standardized heterogeneity ratio (SHR), and standardized nephrographic reduction rate (SNRR). Spearman's correlation analysis was performed to evaluate the relationship between SHR and HS. Univariate and multivariate logistic regression analyses were employed to identify independent risk factors and then CT-score was adjusted by those indicators. The diagnostic efficacy of the modified CT-scores was evaluated using ROC curve analysis. Results The SHR and heterogeneity grade (HG) of mass were correlated positively with the HS (R = 0.749, 0.730, all P < 0.001). Logistic regression analysis determined that the Major axis / Minor axis (> 1.16), the tumor-renal interface (> 22.3 mm), and the SNRR (> 0.16) as additional independent risk factors to combine with HS and MCAR. Compared to the original CT-score, the two CT algorithms combined tumor-renal interface and SNRR showed significantly improved diagnostic efficacy for ccRCC (AUC: 0.770 vs. 0.861 and 0.862, all P < 0.001). The inter-observer agreement for HG was higher than that for HS (weighted Kappa coefficient: 0.797 vs. 0.722). The consistency of modified CT-score was also superior to original CT-score (weighted Kappa coefficient: 0.935 vs. 0.878). Conclusion The modified CT algorithms not only enhanced inter-reader consistency but also improved the diagnostic capability for ccRCC in small renal masses.https://doi.org/10.1186/s40644-025-00847-3Clear-cell renal cell carcinomaRenal massActive surveillanceCTHeterogeneity |
| spellingShingle | Pengfei Jin Linghui Zhang Hong Yang Tingting Jiang Chenyang Xu Jiehui Huang Zhongyu Zhang Lei Shi Xu Wang Development of modified multi-parametric CT algorithms for diagnosing clear-cell renal cell carcinoma in small solid renal masses Cancer Imaging Clear-cell renal cell carcinoma Renal mass Active surveillance CT Heterogeneity |
| title | Development of modified multi-parametric CT algorithms for diagnosing clear-cell renal cell carcinoma in small solid renal masses |
| title_full | Development of modified multi-parametric CT algorithms for diagnosing clear-cell renal cell carcinoma in small solid renal masses |
| title_fullStr | Development of modified multi-parametric CT algorithms for diagnosing clear-cell renal cell carcinoma in small solid renal masses |
| title_full_unstemmed | Development of modified multi-parametric CT algorithms for diagnosing clear-cell renal cell carcinoma in small solid renal masses |
| title_short | Development of modified multi-parametric CT algorithms for diagnosing clear-cell renal cell carcinoma in small solid renal masses |
| title_sort | development of modified multi parametric ct algorithms for diagnosing clear cell renal cell carcinoma in small solid renal masses |
| topic | Clear-cell renal cell carcinoma Renal mass Active surveillance CT Heterogeneity |
| url | https://doi.org/10.1186/s40644-025-00847-3 |
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