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MRI radiomics-based nomogram for individualised prediction of synchronous distant metastasis in patients with clear cell renal cell carcinoma

  • Imaging Informatics and Artificial Intelligence
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objective

To evaluate the performance of a multiparametric MRI radiomics-based nomogram for the individualised prediction of synchronous distant metastasis (SDM) in patients with clear cell renal cell carcinoma (ccRCC).

Methods

Two-hundred and one patients (training cohort: n = 126; internal validation cohort: n = 39; external validation cohort: n = 36) with ccRCC were retrospectively enrolled between January 2013 and June 2019. In the training cohort, the optimal MRI radiomics features were selected and combined to calculate the radiomics score (Rad-score). Incorporating Rad-score and SDM-related clinicoradiologic characteristics, the radiomics-based nomogram was established by multivariable logistic regression analysis, then the performance of the nomogram (discrimination and clinical usefulness) was evaluated and validated subsequently. Moreover, the prediction efficacy for SDM in ccRCC subgroups of different sizes was also assessed.

Results

Incorporating Rad-score derived from 9 optimal MR radiomics features (age, pseudocapsule and regional lymph node), the radiomics-based nomogram was capable of predicting SDM in the training cohort (area under the ROC curve (AUC) = 0.914) and validated in both the internal and external cohorts (AUC = 0.854 and 0.816, respectively) and also showed a convincing predictive power in ccRCC subgroups of different sizes (≤ 4 cm, AUC = 0.875; 4–7 cm, AUC = 0.891; 7–10 cm, 0.908; > 10 cm, AUC = 0.881). Decision curve analysis indicated that the radiomics-based nomogram is of clinical usefulness.

Conclusions

The multiparametric MRI radiomics-based nomogram could achieve precise individualised prediction of SDM in patients with ccRCC, potentially improving the management of ccRCC.

Key Points

• Radiomics features derived from multiparametric magnetic resonance images showed relevant association with synchronous distant metastasis in clear cell renal cell carcinoma.

• MRI radiomics-based nomogram may serve as a potential tool for the risk prediction of synchronous distant metastasis in clear cell renal cell carcinoma.

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Abbreviations

AUC:

Area under the ROC curve

ccRCC:

Clear cell renal cell carcinoma

DCA:

Decision curve analysis

EP:

Excretory phase

MRI:

Magnetic resonance imaging

Rad-score:

Radiomics score

RLN:

Regional lymph node

ROC:

Receiver operating characteristic

SDM:

Synchronous distant metastasis

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Acknowledgements

We thank Dr. Lin Li (PhD) (Professor, Medical Statistics, Institute for Hospital Management Research, Chinese PLA General Hospital) for his guidance on the statistical analysis in this study.

Funding

We acknowledge the financial support from the National Natural Science Foundation of China (Grant No. 81971580) and from the Medical Big Data Research and Development Project supported by Chinese PLA General Hospital (Grant No. 2018MBD-023).

Author information

Authors and Affiliations

  1. Medical School of Chinese PLA, No. 28 Fuxing Road, Haidian District, Beijing, 100853, China

    Xu Bai

  2. Department of Radiology, First Medical Centre, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing, 100853, China

    Xu Bai, Xiaojing Zhang, Meifeng Wang, Wei Xu, Huiyi Ye & Haiyi Wang

  3. Department of Urology, First Medical Centre, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing, 100853, China

    Qingbo Huang & Xu Zhang

  4. Huiying Medical Technology Co. Ltd., Dongsheng Science and Technology Park, Haidian District, Beijing, 100192, China

    Panli Zuo

  5. Department of Pathology, First Medical Centre, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing, 100853, China

    Jing Yuan

  6. Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, North of Huanhu West Road Sports Institute, Hexi District, Tianjin, 300060, China

    Jinkun Zhao

  7. Department of Radiology, Tianjin Medical University General Hospital, No. 154 Anshan Road, Heping District, Tianjin, 300052, China

    Haoran Sun

  8. Department of Radiology, Weihai Central Hospital, No. 3 West Part of Mishan East Road, Wendeng District, Weihai, 264400, Shandong, China

    Bin Shao

Authors
  1. Xu Bai
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  2. Qingbo Huang
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  3. Panli Zuo
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  4. Xiaojing Zhang
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  5. Jing Yuan
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  6. Xu Zhang
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  7. Meifeng Wang
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  8. Wei Xu
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  9. Huiyi Ye
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  10. Jinkun Zhao
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  11. Haoran Sun
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  12. Bin Shao
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  13. Haiyi Wang
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Corresponding author

Correspondence to Haiyi Wang.

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The scientific guarantor of this publication is Dr. Haiyi Wang.

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The authors of this manuscript declare no conflict of interests.

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No complex statistical methods were necessary for this paper.

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Institutional review board approval was obtained.

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• Retrospective

• Diagnostic or prognostic study

• Multicentre study

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Bai, X., Huang, Q., Zuo, P. et al. MRI radiomics-based nomogram for individualised prediction of synchronous distant metastasis in patients with clear cell renal cell carcinoma. Eur Radiol 31, 1029–1042 (2021). https://doi.org/10.1007/s00330-020-07184-y

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  • DOI: https://doi.org/10.1007/s00330-020-07184-y

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