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Khene ZE, Bhanvadia R, Tachibana I, Sharma P, Trevino I, Graber W, Bertail T, Fleury R, Acosta O, De Crevoisier R, Bensalah K, Lotan Y, Margulis V. Impact of contrast enhancement phase on CT-based radiomics analysis for predicting post-surgical recurrence in renal cell carcinoma. Jpn J Radiol 2025; 43:977-984. [PMID: 39907976 DOI: 10.1007/s11604-025-01740-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2024] [Accepted: 01/09/2025] [Indexed: 02/06/2025]
Abstract
PURPOSE To investigate the effect of CT enhancement phase on radiomics features for predicting post-surgical recurrence of clear cell renal cell carcinoma (ccRCC). METHODS This retrospective study included 144 patients who underwent radical or partial nephrectomy for ccRCC. Preoperative multiphase abdominal CT scans (non-contrast, corticomedullary, and nephrographic phases) were obtained for each patient. Automated segmentation of renal masses was performed using the nnU-Net framework. Radiomics signatures (RS) were developed for each phase using ensembles of machine learning-based models (Random Survival Forests [RSF], Survival Support Vector Machines [S-SVM], and Extreme Gradient Boosting [XGBoost]) with and without feature selection. Feature selection was performed using Affinity Propagation Clustering. The primary endpoint was disease-free survival, assessed by concordance index (C-index). RESULTS The study included 144 patients. Radical and partial nephrectomies were performed in 81% and 19% of patients, respectively, with 81% of tumors classified as high grade. Disease recurrence occurred in 74 patients (51%). A total of 1,316 radiomics features were extracted per phase per patient. Without feature selection, C-index values for RSF, S-SVM, XGBoost, and Penalized Cox models ranged from 0.43 to 0.61 across phases. With Affinity Propagation feature selection, C-index values improved to 0.51-0.74, with the corticomedullary phase achieving the highest performance (C-index up to 0.74). CONCLUSIONS The results of our study indicate that radiomics analysis of corticomedullary phase contrast-enhanced CT images may provide valuable predictive insight into recurrence risk for non-metastatic ccRCC following surgical resection. However, the lack of external validation is a limitation, and further studies are needed to confirm these findings in independent cohorts.
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Affiliation(s)
- Zine-Eddine Khene
- Department of Urology, University of Texas Southwestern Medical Center, 2001 Inwood Rd, WCB3, Floor 4, Dallas, TX, 75390, USA.
- Department of Urology, University of Rennes, Rennes, France.
- Image and Signal Processing Laboratory, Inserm U1099, University of Rennes, Rennes, France.
| | - Raj Bhanvadia
- Department of Urology, University of Texas Southwestern Medical Center, 2001 Inwood Rd, WCB3, Floor 4, Dallas, TX, 75390, USA
| | - Isamu Tachibana
- Department of Urology, University of Texas Southwestern Medical Center, 2001 Inwood Rd, WCB3, Floor 4, Dallas, TX, 75390, USA
| | - Prajwal Sharma
- Department of Urology, University of Texas Southwestern Medical Center, 2001 Inwood Rd, WCB3, Floor 4, Dallas, TX, 75390, USA
| | - Ivan Trevino
- Department of Urology, University of Texas Southwestern Medical Center, 2001 Inwood Rd, WCB3, Floor 4, Dallas, TX, 75390, USA
| | - William Graber
- Department of Urology, University of Texas Southwestern Medical Center, 2001 Inwood Rd, WCB3, Floor 4, Dallas, TX, 75390, USA
| | | | - Raphael Fleury
- Department of Urology, University of Rennes, Rennes, France
| | - Oscar Acosta
- Image and Signal Processing Laboratory, Inserm U1099, University of Rennes, Rennes, France
| | - Renaud De Crevoisier
- Image and Signal Processing Laboratory, Inserm U1099, University of Rennes, Rennes, France
- Department of Radiation Oncology, CLCC Eugene Marquis, Rennes, France
| | - Karim Bensalah
- Department of Urology, University of Rennes, Rennes, France
| | - Yair Lotan
- Department of Urology, University of Texas Southwestern Medical Center, 2001 Inwood Rd, WCB3, Floor 4, Dallas, TX, 75390, USA
| | - Vitaly Margulis
- Department of Urology, University of Texas Southwestern Medical Center, 2001 Inwood Rd, WCB3, Floor 4, Dallas, TX, 75390, USA
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