Machine learning-based quantitative texture analysis of CT images of small renal masses: Differentiation of angiomyolipoma without visible fat from renal cell carcinoma

European Radiology - Tập 28 - Trang 1625-1633 - 2017
Zhichao Feng1, Pengfei Rong1, Peng Cao2, Qingyu Zhou1, Wenwei Zhu1, Zhimin Yan1, Qianyun Liu1, Wei Wang1
1Department of Radiology, The Third Xiangya Hospital, Central South University, Changsha, China
2GE Healthcare, Shanghai, China

Tóm tắt

To evaluate the diagnostic performance of machine-learning based quantitative texture analysis of CT images to differentiate small (≤ 4 cm) angiomyolipoma without visible fat (AMLwvf) from renal cell carcinoma (RCC). This single-institutional retrospective study included 58 patients with pathologically proven small renal mass (17 in AMLwvf and 41 in RCC groups). Texture features were extracted from the largest possible tumorous regions of interest (ROIs) by manual segmentation in preoperative three-phase CT images. Interobserver reliability and the Mann-Whitney U test were applied to select features preliminarily. Then support vector machine with recursive feature elimination (SVM-RFE) and synthetic minority oversampling technique (SMOTE) were adopted to establish discriminative classifiers, and the performance of classifiers was assessed. Of the 42 extracted features, 16 candidate features showed significant intergroup differences (P < 0.05) and had good interobserver agreement. An optimal feature subset including 11 features was further selected by the SVM-RFE method. The SVM-RFE+SMOTE classifier achieved the best performance in discriminating between small AMLwvf and RCC, with the highest accuracy, sensitivity, specificity and AUC of 93.9 %, 87.8 %, 100 % and 0.955, respectively. Machine learning analysis of CT texture features can facilitate the accurate differentiation of small AMLwvf from RCC. • Although conventional CT is useful for diagnosis of SRMs, it has limitations. • Machine-learning based CT texture analysis facilitate differentiation of small AMLwvf from RCC. • The highest accuracy of SVM-RFE+SMOTE classifier reached 93.9 %. • Texture analysis combined with machine-learning methods might spare unnecessary surgery for AMLwvf.

Tài liệu tham khảo

Kutikov A, Fossett LK, Ramchandani P et al (2006) Incidence of benign pathologic findings at partial nephrectomy for solitary renal mass presumed to be renal cell carcinoma on preoperative imaging. Urology 68:737–740 Fujii Y, Komai Y, Saito K et al (2008) Incidence of benign pathologic lesions at partial nephrectomy for presumed RCC renal masses: Japanese dual-center experience with 176 consecutive patients. Urology 72:598–602 Flum AS, Hamoui N, Said MA et al (2016) Update on the Diagnosis and Management of Renal Angiomyolipoma. J Urol 195:834–846 Umbreit EC, Shimko MS, Childs MA et al (2012) Metastatic potential of a renal mass according to original tumour size at presentation. Bju Int 109:190–194 discussion 194 Kim JK, Park SY, Shon JH et al (2004) Angiomyolipoma with minimal fat: differentiation from renal cell carcinoma at biphasic helical CT. Radiology 230:677–684 Zhang YY, Luo S, Liu Y et al (2013) Angiomyolipoma with minimal fat: differentiation from papillary renal cell carcinoma by helical CT. Clin Radiol 68:365–370 Hakim SW, Schieda N, Hodgdon T et al (2016) Angiomyolipoma (AML) without visible fat: Ultrasound, CT and MR imaging features with pathological correlation. Eur Radiol 26:592–600 Yang CW, Shen SH, Chang YH et al (2013) Are there useful CT features to differentiate renal cell carcinoma from lipid-poor renal angiomyolipoma? AJR Am J Roentgenol 201:1017–1028 Xie P, Yang Z, Yuan Z (2016) Lipid-poor renal angiomyolipoma: Differentiation from clear cell renal cell carcinoma using wash-in and washout characteristics on contrast-enhanced computed tomography. Oncol Lett 11:2327–2331 Davnall F, Yip CS, Ljungqvist G et al (2012) Assessment of tumor heterogeneity: an emerging imaging tool for clinical practice? Insights Imaging 3:573–589 Hodgdon T, Mcinnes MD, Schieda N et al (2015) Can Quantitative CT Texture Analysis be Used to Differentiate Fat-poor Renal Angiomyolipoma from Renal Cell Carcinoma on Unenhanced CT Images? Radiology 276:787–796 Yan L, Liu Z, Wang G et al (2015) Angiomyolipoma with minimal fat: differentiation from clear cell renal cell carcinoma and papillary renal cell carcinoma by texture analysis on CT images. Acad Radiol 22:1115–1121 Kumar V, Gu Y, Basu S et al (2012) Radiomics: the process and the challenges. Magn Reson Imaging 30:1234–1248 Parmar C, Grossmann P, Bussink J et al (2015) Machine Learning methods for Quantitative Radiomic Biomarkers. Sci Rep 5:13087 Zhang X, Yan LF, Hu YC et al (2017) Optimizing a machine learning based glioma grading system using multi-parametric MRI histogram and texture features. Oncotarget 8:47816–47830 Nketiah G, Elschot M, Kim E et al (2017) T2-weighted MRI-derived textural features reflect prostate cancer aggressiveness: preliminary results. Eur Radiol 27:3050–3059 Wibmer A, Hricak H, Gondo T et al (2015) Haralick texture analysis of prostate MRI: utility for differentiating non-cancerous prostate from prostate cancer and differentiating prostate cancers with different Gleason scores. Eur Radiol 25:2840–2850 Aerts HJ, Velazquez ER, Leijenaar RT et al (2014) Decoding tumour phenotype by noninvasive imaging using a quantitative radiomics approach. Nat Commun 5:4006 Guyon I, Weston J, Barnhill S et al (2002) Gene selection for cancer classification using support vector machines. Mach Learn 46:389–422 Fehr D, Veeraraghavan H, Wibmer A et al (2015) Automatic classification of prostate cancer Gleason scores from multiparametric magnetic resonance images. Proc Natl Acad Sci 112:E6265–E6273 Wang J, Wu C J, Bao M L et al (2017) Machine learning-based analysis of MR radiomics can help to improve the diagnostic performance of PI-RADS v2 in clinically relevant prostate cancer. Eur Radiol. https:/doi.org/10.1007/s00330-017-4800-5 Zhang X, Xu X, Tian Q, et al (2017) Radiomics assessment of bladder cancer grade using texture features from diffusion-weighted imaging. J Magn Reson Imaging 46: 1281-1288 Chawla NV, Bowyer KW, Hall LO et al (2011) SMOTE: synthetic minority over-sampling technique. J Artif Intell Res 16:321–357 Zhang Y, Oikonomou A, Wong A et al (2017) Radiomics-based Prognosis Analysis for Non-Small Cell Lung Cancer. Sci Rep 7:46349 Yu H, Scalera J, Khalid M et al (2017) Texture analysis as a radiomic marker for differentiating renal tumors. Abdom Radiol (NY). https:/doi.org/10.1007/s00261-017-1144-1 Lee HS, Hong H, Jung DC et al (2017) Differentiation of fat-poor angiomyolipoma from clear cell renal cell carcinoma in contrast-enhanced MDCT images using quantitative feature classification. Med Phys 44:3604–3614 Lin X, Yang F, Zhou L et al (2012) A support vector machine-recursive feature elimination feature selection method based on artificial contrast variables and mutual information. J Chromatogr B Analyt Technol Biomed Life Sci 910:149–155 Jinzaki M, Tanimoto A, Narimatsu Y et al (1997) Angiomyolipoma: imaging findings in lesions with minimal fat. Radiology 205:497–502 Tsukada J, Jinzaki M, Yao M et al (2013) Epithelioid angiomyolipoma of the kidney: radiological imaging. Int J Urol 20:1105–1111 Ishigami K, Pakalniskis MG, Leite LV et al (2015) Characterization of renal cell carcinoma, oncocytoma, and lipid-poor angiomyolipoma by unenhanced, nephrographic, and delayed phase contrast-enhanced computed tomography. Clin Imaging 39:76–84 Silverman SG, Mortele KJ, Tuncali K et al (2007) Hyperattenuating renal masses: etiologies, pathogenesis, and imaging evaluation. Radiographics 27:1131–1143 Liu S, Zheng H, Zhang Y et al (2017) Whole-volume apparent diffusion coefficient-based entropy parameters for assessment of gastric cancer aggressiveness. J Magn Reson Imaging. https:/doi.org/10.1002/jmri.25752 Choi ER, Lee HY, Jeong JY et al (2016) Quantitative image variables reflect the intratumoral pathologic heterogeneity of lung adenocarcinoma. Oncotarget 7:67302–67313 Sidhu HS, Benigno S, Ganeshan B et al (2017) Textural analysis of multiparametric MRI detects transition zone prostate cancer. Eur Radiol 27:2348–2358 Hanahan D, Weinberg RA (2011) Hallmarks of cancer: the next generation. Cell 144:646–674 Johnson PT, Horton KM, Fishman EK (2010) How not to miss or mischaracterize a renal cell carcinoma: protocols, pearls, and pitfalls. AJR Am J Roentgenol 194:W307–W315 Takahashi N, Leng S, Kitajima K et al (2015) Small (< 4 cm) Renal Masses: Differentiation of Angiomyolipoma Without Visible Fat From Renal Cell Carcinoma Using Unenhanced and Contrast-Enhanced CT. AJR Am J Roentgenol 205:1194–1202 Xu X, Liu Y, Zhang X et al (2017) Preoperative prediction of muscular invasiveness of bladder cancer with radiomic features on conventional MRI and its high-order derivative maps. Abdom Radiol (NY) 42:1896–1905 Yip SSF, Parmar C, Blezek D et al (2017) Application of the 3D slicer chest imaging platform segmentation algorithm for large lung nodule delineation. Plos One 12:e0178944 Ng F, Kozarski R, Ganeshan B et al (2013) Assessment of tumor heterogeneity by CT texture analysis: can the largest cross-sectional area be used as an alternative to whole tumor analysis? Eur J Radiol 82:342–348