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Texture analysis of small renal cell carcinomas at MDCT for predicting relevant histologic and protein biomarkers

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Abstract

Purpose

To assess CT texture features of small renal cell carcinomas (≤ 4cm) for association with key pathologic features including protein biomarkers.

Methods

Quantitative CT texture analysis (CTTA) of small renal cancers (≤ 4cm) was performed on non-contrast and portal venous phase abdominal MDCT scans with an ROI drawn at the largest cross-sectional diameter of the tumor using commercially available software. Texture parameters including mean pixel attenuation, the standard deviation (SD) of the pixel distribution histogram, entropy, the mean of positive pixels, the skewness (i.e., asymmetry) of the pixel histogram, kurtosis (i.e., peakness) of the pixel histogram, and the percentage of positive pixels were correlated with pathologic data from surgical resection, including histology and nuclear grade, as well as microarray analysis in a subset (n = 40) including Ki67 index, CRP, and neovascularization (CD105/CD31).

Results

Portal venous phase images were available in 249 patients (105 women, 144 men; mean age, 56.7 years) with tumors ≤ 4cm (mean, median, range, ± SD; 2.66, 2.60, 0.3–4.0 ± 0.85 cm). CT texture features of standard deviation, mean of the positive pixels, and entropy of the pixel histogram were significantly associated with histologic cell type (clear vs. non-clear; p < 0.001). Entropy and mean of the positive pixels also showed an association with nuclear grade, although not statistically significant. In the microarray analysis subset, kurtosis of the pixel histogram was associated with CD105/CD31 (p = 0.05). SD also showed some association with CD 105 positivity (p = 0.02) and CAIX expression (p = 0.01). Non-contrast CT images were available in 174 patients (72 women, 102 men; mean age, 57.5 years). Although the association with histology was not as strong as on the portal venous phase, in the subset of patients with microarray data, SD was found to correlate with CRP (p = 0.08), kurtosis with CRP (p = 0.004), CD105/CD31 (p = 0.002), and with Ki 67 index (p < 0.001).

Conclusion

CT texture features were significantly associated with important histopathologic features in small renal cancers. These non-invasive measures can be performed retrospectively and may provide useful information when determining follow-up and treatment of small renal cancers.

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Authors and Affiliations

  1. Department of Radiology, University of Wisconsin School of Medicine and Public Health, E3/311 Clinical Sciences Center, 600 Highland Ave, Madison, WI, 53792, USA

    Andrew T. Scrima, Meghan G. Lubner & Perry J. Pickhardt

  2. Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, USA

    E. Jason Abel & Daniel D. Shapiro

  3. Department of Biostatistics, University of Wisconsin School of Medicine and Public Health, Madison, USA

    Thomas C. Havighurst

  4. Department of Pathology, University of Wisconsin School of Medicine and Public Health, Madison, USA

    Wei Huang

Authors
  1. Andrew T. Scrima
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  2. Meghan G. Lubner
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  3. E. Jason Abel
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  4. Thomas C. Havighurst
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  5. Daniel D. Shapiro
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  6. Wei Huang
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  7. Perry J. Pickhardt
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Corresponding author

Correspondence to Meghan G. Lubner.

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Funding

Funding support was provided by University of Wisconsin School of Medicine and Public Health Shapiro program and Department of Radiology Research and Development.

Disclosures

MGL: Grant funding Philips, Ethicon. PJP: co-founder of VirtuoCTC, consultant for Bracco and Check-Cap, and shareholder in SHINE, Elucent, and Cellectar Biosciences. No other disclosures from the other authors

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The need for informed consent was waived.

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Scrima, A.T., Lubner, M.G., Abel, E.J. et al. Texture analysis of small renal cell carcinomas at MDCT for predicting relevant histologic and protein biomarkers. Abdom Radiol 44, 1999–2008 (2019). https://doi.org/10.1007/s00261-018-1649-2

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  • DOI: https://doi.org/10.1007/s00261-018-1649-2

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