title: Angiomyolipoma with minimal fat: differentiation from clear cell renal cell carcinoma and papillary renal cell carcinoma by texture analysis on CT images.
abstract: OBJECTIVE
  To retrospectively evaluate the diagnostic performance of texture analysis (TA) for the discrimination of angiomyolipoma (AML) with minimal fat, clear cell renal cell cancer (ccRCC), and papillary renal cell cancer (pRCC) on computed tomography (CT) images and to determine the scanning phase, which contains the strongest discriminative power.
  
  
  METHODS
  Patients with pathologically proved AMLs (n = 18) lacking visible macroscopic fat at CT and patients with pathologically proved ccRCCs (n = 18) and pRCCs (n = 14) were included. All patients underwent CT scan with three phases (precontrast phase [PCP], corticomedullary phase [CMP], and nephrographic phase [NP]). The selected images were analyzed and classified with TA software (MaZda). Texture classification was performed for 1) minimal fat AML versus ccRCC, 2) minimal fat AML versus pRCC, and 3) ccRCC versus pRCC. The classification results were arbitrarily divided into several levels according to the misclassification rates: excellent (misclassification rates ≤10%), good (10%< misclassification rates ≤20%), moderate (20%< misclassification rates ≤30%), fair (30%< misclassification rates ≤40%), and poor (misclassification rates ≥40%).
  
  
  RESULTS
  Excellent classification results (error of 0.00%-9.30%) were obtained with nonlinear discriminant analysis for all the three groups, no matter which phase was used. On comparison of the three scanning phases, we observed a trend toward better lesion classification with PCP for minimal fat AML versus ccRCC, CMP, and NP images for ccRCC versus pRCC and found similar discriminative power for minimal fat AML versus pRCC.
  
  
  CONCLUSIONS
  TA might be a reliable quantitative method for the discrimination of minimal fat AML, ccRCC, and pRCC.
authors.affiliation: Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, 106 Zhong Shan Er Lu, Guangzhou, Guangdong Province 510080, China.
authors.forename: Lifen
authors.initials: L
authors.lastname: Yan
authors.affiliation: Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, 106 Zhong Shan Er Lu, Guangzhou, Guangdong Province 510080, China.
authors.forename: Zaiyi
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, 106 Zhong Shan Er Lu, Guangzhou, Guangdong Province 510080, China.
authors.forename: Guangyi
authors.initials: G
authors.lastname: Wang
authors.affiliation: Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, 106 Zhong Shan Er Lu, Guangzhou, Guangdong Province 510080, China.
authors.forename: Yanqi
authors.initials: Y
authors.lastname: Huang
authors.affiliation: Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, 106 Zhong Shan Er Lu, Guangzhou, Guangdong Province 510080, China.
authors.forename: Yubao
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, 106 Zhong Shan Er Lu, Guangzhou, Guangdong Province 510080, China.
authors.forename: Yuanxin
authors.initials: Y
authors.lastname: Yu
authors.affiliation: Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, 106 Zhong Shan Er Lu, Guangzhou, Guangdong Province 510080, China. Electronic address: cjr.lchh@vip.163.com.
authors.forename: Changhong
authors.initials: C
authors.lastname: Liang
mesh_terms: D000273:Adipose Tissue / Q000000981:diagnostic imaging; D000328:Adult; D000368:Aged; D018207:Angiomyolipoma / Q000000981:diagnostic imaging*; D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging*; D002454:Cell Differentiation; D015331:Cohort Studies; D003287:Contrast Media / Q000008:administration & dosage; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D007672:Kidney Cortex / Q000000981:diagnostic imaging; D007679:Kidney Medulla / Q000000981:diagnostic imaging; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D012189:Retrospective Studies
chemical_list: D003287:Contrast Media
keywords: Texture analysis; angiomyolipoma; computed tomography; renal cell carcinoma