Radiomics features for differentiating clear cell sarcoma of the kidney
from Wilms’ tumor in children based on contrast-enhanced computed
tomography: a case-control study
Abstract
Background: Clear cell sarcoma of the kidney (CCSK) is a rare but the
second common renal malignant tumor mimicking Wilms’ tumor. Radiomics is
helpful for differentiating CCSK from Wilms’ tumor preoperatively
through analyzing the pixel distribution of lesions on medical images
quantitatively. Procedure: In this study, the regions of interest (ROIs)
of lesions were delineated on corticomedullary phase (CMP) and
nephrographic phase (NP) images to extract radiomics features.
Dimensionality reduction and Logistic Regression (LR) algorithm were
used to construct the classification models. The area under the receiver
operator characteristic curve (AUC), sensitivity and specificity were
calculated for evaluation, and Delong test was used to compare the
performance of the most meaningful features and LR models. Results:
Lower skewness was observed in Wilms’ tumor, and higher skewness in
CCSK. Skewness transformed by exponential and squareroot filters from NP
images achieved moderate to good diagnostic performance for CCSK with
AUCs of 0.707 (95%CI: 0.573, 0.840) and 0.705 (95%CI: 0.572, 0.839) in
the training set, and 0.818 (95%CI: 0.608, 1.000) and 0.803 (95%CI:
0.585, 1.000) in the validation set, respectively. Delong test showed no
significant difference between LR model, exponential-skewness and
squareroot-skewness based on NP images in both training and validation
sets. Conclusion: Skewness from nephrographic phase at exponential and
squareroot filters is helpful to discriminate between CCSK and Wilms’
tumor in children, and higher skewness on NP images may be a potential
imaging biomarker for diagnosing CCSK from Wilms’ tumor.