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      CT−based radiomics signature for differentiating pyelocaliceal upper urinary tract urothelial carcinoma from infiltrative renal cell carcinoma

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          Abstract

          Objectives

          To develop a CT-based radiomics model and a combined model for preoperatively discriminating infiltrative renal cell carcinoma (RCC) and pyelocaliceal upper urinary tract urothelial carcinoma (UTUC), which invades the renal parenchyma.

          Materials and methods

          Eighty patients (37 pathologically proven infiltrative RCCs and 43 pathologically proven pyelocaliceal UTUCs) were retrospectively enrolled and randomly divided into a training set (n = 56) and a testing set (n = 24) at a ratio of 7:3. Traditional CT imaging characteristics in the portal venous phase were collected by two radiologists (SPH and ZXL, who have 4 and 30 years of experience in abdominal radiology, respectively). Patient demographics and traditional CT imaging characteristics were used to construct the clinical model. The radiomics score was calculated based on the radiomics features extracted from the portal venous CT images and the random forest (RF) algorithm to construct the radiomics model. The combined model was constructed using the radiomics score and significant clinical factors according to the multivariate logistic regression. The diagnostic efficacy of the models was evaluated using receiver operating characteristic (ROC) curve analysis and the area under the curve (AUC).

          Results

          The RF score based on the eight validated features extracted from the portal venous CT images was used to build the radiomics model. Painless hematuria as an independent risk factor was used to build the clinical model. The combined model was constructed using the RF score and the selected clinical factor. Both the radiomics model and combined model showed higher efficacy in differentiating infiltrative RCC and pyelocaliceal UTUC in the training and testing cohorts with AUC values of 0.95 and 0.90, respectively, for the radiomics model and 0.99 and 0.90, respectively, for the combined model. The decision curves of the combined model as well as the radiomics model indicated an overall net benefit over the clinical model. Both the radiomics model and the combined model achieved a notable reduction in false-positive and false-negativerates, resulting in significantly higher accuracy compared to the visual assessments in both the training and testing cohorts.

          Conclusion

          The radiomics model and combined model had the potential to accurately differentiate infiltrative RCC and pyelocaliceal UTUC, which invades the renal parenchyma, and provide a new potentially non-invasive method to guide surgery strategies.

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          Most cited references28

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          Radiomics: Images Are More than Pictures, They Are Data

          This report describes the process of radiomics, its challenges, and its potential power to facilitate better clinical decision making, particularly in the care of patients with cancer.
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            Computational Radiomics System to Decode the Radiographic Phenotype

            Radiomics aims to quantify phenotypic characteristics on medical imaging through the use of automated algorithms. Radiomic artificial intelligence (AI) technology, either based on engineered hard-coded algorithms or deep learning methods, can be used to develop non-invasive imaging-based biomarkers. However, lack of standardized algorithm definitions and image processing severely hampers reproducibility and comparability of results. To address this issue, we developed PyRadiomics , a flexible open-source platform capable of extracting a large panel of engineered features from medical images. PyRadiomics is implemented in Python and can be used standalone or using 3D-Slicer. Here, we discuss the workflow and architecture of PyRadiomics and demonstrate its application in characterizing lung-lesions. Source code, documentation, and examples are publicly available at www.radiomics.io . With this platform, we aim to establish a reference standard for radiomic analyses, provide a tested and maintained resource, and to grow the community of radiomic developers addressing critical needs in cancer research.
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              Radiomics: the bridge between medical imaging and personalized medicine

              Radiomics, the high-throughput mining of quantitative image features from standard-of-care medical imaging that enables data to be extracted and applied within clinical-decision support systems to improve diagnostic, prognostic, and predictive accuracy, is gaining importance in cancer research. Radiomic analysis exploits sophisticated image analysis tools and the rapid development and validation of medical imaging data that uses image-based signatures for precision diagnosis and treatment, providing a powerful tool in modern medicine. Herein, we describe the process of radiomics, its pitfalls, challenges, opportunities, and its capacity to improve clinical decision making, emphasizing the utility for patients with cancer. Currently, the field of radiomics lacks standardized evaluation of both the scientific integrity and the clinical relevance of the numerous published radiomics investigations resulting from the rapid growth of this area. Rigorous evaluation criteria and reporting guidelines need to be established in order for radiomics to mature as a discipline. Herein, we provide guidance for investigations to meet this urgent need in the field of radiomics.
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                Author and article information

                Contributors
                Journal
                Front Oncol
                Front Oncol
                Front. Oncol.
                Frontiers in Oncology
                Frontiers Media S.A.
                2234-943X
                18 January 2024
                2023
                : 13
                : 1244585
                Affiliations
                [1] 1 Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University , Beijing, China
                [2] 2 CT Collaboration, Siemens Healthineers Ltd. , Beijing, China
                [3] 3 Department of Pathology, Beijing Chaoyang Hospital, Capital Medical University , Beijing, China
                [4] 4 Huiying Medical Technology (Beijing) Co., Ltd. , Beijing, China
                Author notes

                Edited by: Eros Montin, New York University, United States

                Reviewed by: Hector Lise De Moura, New York University, United States

                Lucilla Violetta Sciacqua, Università degli studi di Milano, Italy

                Pal Kaposi, Semmelweis University, Hungary

                *Correspondence: Penghui Sun, sunph199624@ 123456163.com

                †These authors have contributed equally to this work and share first authorship

                Article
                10.3389/fonc.2023.1244585
                10830825
                38304033
                1301a6e8-02a2-4c5e-89fb-d4ccc395161f
                Copyright © 2024 Zhai, Sun, Yu, Wang, Li, Sun, Liu, Tian and Zhang

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 22 June 2023
                : 22 December 2023
                Page count
                Figures: 7, Tables: 3, Equations: 0, References: 28, Pages: 10, Words: 3489
                Funding
                The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article.
                Categories
                Oncology
                Original Research
                Custom metadata
                Genitourinary Oncology

                Oncology & Radiotherapy
                infiltrative renal cell cancer,pyelocaliceal upper urinary tract urothelial carcinoma,enhanced ct,differentiation,radiomics

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