AUTHOR=Ma Yanqing , Guan Zheng , Liang Hong , Cao Hanbo 

TITLE=Predicting the WHO/ISUP Grade of Clear Cell Renal Cell Carcinoma Through CT-Based Tumoral and Peritumoral Radiomics

JOURNAL=Frontiers in Oncology

VOLUME=Volume 12 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2022.831112

DOI=10.3389/fonc.2022.831112

ISSN=2234-943X

ABSTRACT=Objectives To establish predictive logistic models for the World Health Organization/International Society of Urological Pathology (WHO/ISUP) grades of clear cell renal cell carcinoma (ccRCC) based on tumoral and peritumoral radiomics. 
Methods A cohort of 370 patients with pathologically confirmed ccRCCs were included between January 2014 to December 2020 according to the WHO/ISUP grading system in this retrospective study. The volume of interests of triphasic computed tomography images were depicted manually in software of “itk-SNAP” and the radiomic features were calculated. The cohort was segmented into the training cohort and validation cohort with a random proportion of 7:3. After extraction of radiomic features by methods of variance or Mann-Whitney U test, correlation analysis, and least absolute shrinkage and selection operator, the logistic models of tumoral radiomics (LR-tumor) and peritumoral radiomics (LR-peritumor) were developed. The LR-peritumor contained LR-tumor-2mm, LR-tumor-5mm, and LR-tumor-10mm, and the LR-peritumor was subdivided into LR-peritumor-kid and LR-peritumor-fat based on the varied neighbors of ccRCCs. Finally, a integrative model of tumoral and peritumoral radiomics (LR-tumor/peritumor) was built. The value of areas under the receiver operator characteristics curve (AUCs) were calculated to assess the efficacy of models. 
Results There were 209 low-grade and 161 high-grade ccRCCs enrolled. The AUCs of LR-tumor in CT images of venous-phase were 0.802 in the training cohort and were 0.796 in the validation cohort. The AUCs were higher in LR-peritumor-2mm than those in LR-peritumor-5mm and LR-peritumor-10mm (training cohort: 0.788 vs. 0.788 and 0.759; validation cohort: 0.787 vs. 0.785 and 0.758). Moreover, the AUCs of LR-peritumor-fat were higher compared with these of LR-peritumor-kid. The LR-tumor/peritumor displayed the highest AUCs of 0.812 in the training cohort and 0.804 in the validation cohort. 
Conclusions The tumoral and peritumoral radiomics helped to predict the WHO/ISUP grades of ccRCCs. To the peritumoral radiomics, the LR-peritumor-2mm and LR-peritumor-fat were suggested of better diagnostic performance.