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Radiomics to better characterize small renal masses

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Abstract

Purpose

Radiomics is a specific field of medical research that uses programmable recognition tools to extract objective information from standard images to combine with clinical data, with the aim of improving diagnostic, prognostic, and predictive accuracy beyond standard visual interpretation. We performed a narrative review of radiomic applications that may support improved characterization of small renal masses (SRM). The main focus of the review was to identify and discuss methods which may accurately differentiate benign from malignant renal masses, specifically between renal cell carcinoma (RCC) subtypes and from angiomyolipoma without visible fat (fat-poor AML) and oncocytoma. Furthermore, prediction of grade, sarcomatoid features, and gene mutations would be of importance in terms of potential clinical utility in prognostic stratification and selecting personalised patient management strategies.

Methods

A detailed search of original articles was performed using the PubMed–MEDLINE database until 20 September 2020 to identify the English literature relevant to radiomics applications in renal tumour assessment. In total, 42 articles were included in the analysis in 3 main categories related to SRM: prediction of benign versus malignant SRM, subtypes, and nuclear grade, and other features of aggressiveness.

Conclusion

Overall, studies reported the superiority of radiomics over expert radiological assessment, but were mainly of retrospective design and therefore of low-quality evidence. However, it is clear that radiomics is an attractive modality that has the potential to improve the non-invasive diagnostic accuracy of SRM imaging and prediction of its natural behaviour. Further prospective validation studies of radiomics are needed to augment management algorithms of SRM.

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Authors and Affiliations

  1. Urology Department, Darent Valley Hospital, Dartford and Gravesham NHS Trust, Dartford, UK

    Teele Kuusk

  2. Specialist Centre for Kidney Cancer, Royal Free London NHS Foundation Trust, London, UK

    Teele Kuusk, Joana B. Neves, Maxine Tran & Axel Bex

  3. UCL Division of Surgery and Interventional Science, London, UK

    Maxine Tran & Axel Bex

  4. Surgical Oncology Division, Urology Department, The Netherlands Cancer Institute, Amsterdam, The Netherlands

    Axel Bex

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  1. Teele Kuusk
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Kuusk, T., Neves, J.B., Tran, M. et al. Radiomics to better characterize small renal masses. World J Urol 39, 2861–2868 (2021). https://doi.org/10.1007/s00345-021-03602-y

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