• Gao Qiu, Zengzheng Dai, and Hua Zhang.
• Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
• Brit J Hosp Med. 2024 Nov 30; 85 (11): 1191-19.

AbstractAims/Background Clear cell renal cell carcinoma (ccRCC) is a common and aggressive form of kidney cancer, where early diagnosis is crucial for improving prognosis and treatment outcomes. Radiomics, which utilizes machine learning techniques, presents a promising approach in medical imaging for the early detection and characterization of such conditions. This study aims to explore the clinical utility of a machine-learning-based radiomics model in the early diagnosis of ccRCC. Methods Case data and abdominal computed tomography (CT) tumour images of patients with ccRCC were obtained from The Cancer Imaging Archive (TCIA) database. The dataset included 31 cases in the training set (19 males and 12 females, with an average age of 58.1 years) and 13 cases in the validation set (8 males and 5 females, with an average age of 69.6 years). The volume of interest (VOI) was manually delineated, slice by slice, along the tumour's edge in cross-sectional images of ccRCC. Radiomics features were extracted from each region of interest (ROI) using the "PyRadiomics" plug-in in 3D Slicer software (version 5.1.0, Massachusetts Institute of Technology and Brigham and Women's Hospital, Boston, MA, USA). Feature selection was performed using Least Absolute Shrinkage and Selection Operator (LASSO) regression analysis, followed by 10-fold cross-validation. The selected radiomics features were then used to construct prediction models based on two different supervised machine learning algorithms: logistic regression and random forest. The diagnostic performance of these models was evaluated using receiver operating characteristic (ROC) curves and calibration curves. Finally, clinical data were integrated with the radiomics features to enhance the prediction model. Results A total of 44 radiomics features were ultimately selected to establish the prediction model based on the training set results. Among the two machine learning models, the logistic regression model demonstrated superior diagnostic performance. An evaluation of model establishment, considering both individual radiomics features (DifferenceVariance, JointEnergy.1, JointEntropy.2, MeanAbsoluteDeviation.7, SmallAreaHighGrayLevelEmphasis.7) and clinical data, indicated that the logistic regression model was stable and exhibited strong diagnostic performance, good calibration, and clinical applicability in patients with ccRCC. When clinical data were combined with radiomics features in the model, the area under the curve (AUC) reached 0.969, with an optimal threshold of -2.290, and sensitivity and specificity values of 89.3% and 95.2%, respectively. The calibration curve also confirmed that the logistic regression model had high calibration accuracy and greater clinical application value. Conclusion This machine-learning-based radiomics prediction model demonstrated significant value in the early diagnosis of clear cell renal cell carcinoma (ccRCC).

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