title: Automated noninvasive classification of renal cancer on multiphase CT.
abstract: OBJECTIVE
  To explore the added value of the shape of renal lesions for classifying renal neoplasms. To investigate the potential of computer-aided analysis of contrast-enhanced computed-tomography (CT) to quantify and classify renal lesions.
  
  
  METHODS
  A computer-aided clinical tool based on adaptive level sets was employed to analyze 125 renal lesions from contrast-enhanced abdominal CT studies of 43 patients. There were 47 cysts and 78 neoplasms: 22 Von Hippel-Lindau (VHL), 16 Birt-Hogg-Dube (BHD), 19 hereditary papillary renal carcinomas (HPRC), and 21 hereditary leiomyomatosis and renal cell cancers (HLRCC). The technique quantified the three-dimensional size and enhancement of lesions. Intrapatient and interphase registration facilitated the study of lesion serial enhancement. The histograms of curvature-related features were used to classify the lesion types. The areas under the curve (AUC) were calculated for receiver operating characteristic curves.
  
  
  RESULTS
  Tumors were robustly segmented with 0.80 overlap (0.98 correlation) between manual and semi-automated quantifications. The method further identified morphological discrepancies between the types of lesions. The classification based on lesion appearance, enhancement and morphology between cysts and cancers showed AUC = 0.98; for BHD + VHL (solid cancers) vs. HPRC + HLRCC AUC = 0.99; for VHL vs. BHD AUC = 0.82; and for HPRC vs. HLRCC AUC = 0.84. All semi-automated classifications were statistically significant (p < 0.05) and superior to the analyses based solely on serial enhancement.
  
  
  CONCLUSIONS
  The computer-aided clinical tool allowed the accurate quantification of cystic, solid, and mixed renal tumors. Cancer types were classified into four categories using their shape and enhancement. Comprehensive imaging biomarkers of renal neoplasms on abdominal CT may facilitate their noninvasive classification, guide clinical management, and monitor responses to drugs or interventions.
authors: Radiology and Imaging Sciences, National Institutes of Health, Bethesda, MD 20892, USA.
authors: Marius George
authors: MG
authors: Linguraru
authors: Shijun
authors: S
authors: Wang
authors: Furhawn
authors: F
authors: Shah
authors: Rabindra
authors: R
authors: Gautam
authors: James
authors: J
authors: Peterson
authors: W Marston
authors: WM
authors: Linehan
authors: Ronald M
authors: RM
authors: Summers
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D019540:Area Under Curve; D001331:Automation; D002291:Carcinoma, Papillary / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D001330:Electronic Data Processing / Q000379:methods; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000145:classification / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D011857:Radiographic Image Interpretation, Computer-Assisted; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed / Q000379:methods*