|
1
|
Mühlbauer J, Egen L, Kowalewski KF, Grilli M, Walach MT, Westhoff N, Nuhn P, Laqua FC, Baessler B, Kriegmair MC. Radiomics in Renal Cell Carcinoma-A Systematic Review and Meta-Analysis. Cancers (Basel) 2021; 13:cancers13061348. [PMID: 33802699 PMCID: PMC8002585 DOI: 10.3390/cancers13061348] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 03/07/2021] [Accepted: 03/10/2021] [Indexed: 12/23/2022] Open
Abstract
Simple Summary Radiomics may answer questions where the conventional interpretation of medical imaging has limitations. The aim of our systematic review and meta-analysis was to assess the (current) status of evidence in the application of radiomics in the field of renal masses. We focused on its role in diagnosis, sub-entity discrimination and treatment response assessment in renal cell carcinoma (RCC) and benign renal masses. Our quantitative synthesis showed promising results in discrimination of tumor dignity, nevertheless, the value added to human assessment remains unclear and should be the focus of future research. Furthermore, the benefit regarding treatment response assessment remains unclear as well, since the existing studies are investigating already abandoned systemic therapies (ST), which no longer represent the current “reference” standard. Open science could enable to establish technical and clinical validity of radiomic signatures prior to the incorporation of radiomics into everyday clinical practice. Abstract Radiomics may increase the diagnostic accuracy of medical imaging for localized and metastatic RCC (mRCC). A systematic review and meta-analysis was performed. Doing so, we comprehensively searched literature databases until May 2020. Studies investigating the diagnostic value of radiomics in differentiation of localized renal tumors and assessment of treatment response to ST in mRCC were included and assessed with respect to their quality using the radiomics quality score (RQS). A total of 113 out of 1098 identified studies met the criteria and were included in qualitative synthesis. Median RQS of all studies was 13.9% (5.0 points, IQR 0.25–7.0 points), and RQS increased over time. Thirty studies were included into the quantitative synthesis: For distinguishing angiomyolipoma, oncocytoma or unspecified benign tumors from RCC, the random effects model showed a log odds ratio (OR) of 2.89 (95%-CI 2.40–3.39, p < 0.001), 3.08 (95%-CI 2.09–4.06, p < 0.001) and 3.57 (95%-CI 2.69–4.45, p < 0.001), respectively. For the general discrimination of benign tumors from RCC log OR was 3.17 (95%-CI 2.73–3.62, p < 0.001). Inhomogeneity of the available studies assessing treatment response in mRCC prevented any meaningful meta-analysis. The application of radiomics seems promising for discrimination of renal tumor dignity. Shared data and open science may assist in improving reproducibility of future studies.
Collapse
Affiliation(s)
- Julia Mühlbauer
- Department of Urology and Urological Surgery, University Medical Center Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany; (J.M.); (L.E.); (K.-F.K.); (M.T.W.); (N.W.); (P.N.)
| | - Luisa Egen
- Department of Urology and Urological Surgery, University Medical Center Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany; (J.M.); (L.E.); (K.-F.K.); (M.T.W.); (N.W.); (P.N.)
| | - Karl-Friedrich Kowalewski
- Department of Urology and Urological Surgery, University Medical Center Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany; (J.M.); (L.E.); (K.-F.K.); (M.T.W.); (N.W.); (P.N.)
| | - Maurizio Grilli
- Library of the Medical Faculty Mannheim of the University of Heidelberg, University Medical Center Mannheim, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany;
| | - Margarete T. Walach
- Department of Urology and Urological Surgery, University Medical Center Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany; (J.M.); (L.E.); (K.-F.K.); (M.T.W.); (N.W.); (P.N.)
| | - Niklas Westhoff
- Department of Urology and Urological Surgery, University Medical Center Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany; (J.M.); (L.E.); (K.-F.K.); (M.T.W.); (N.W.); (P.N.)
| | - Philipp Nuhn
- Department of Urology and Urological Surgery, University Medical Center Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany; (J.M.); (L.E.); (K.-F.K.); (M.T.W.); (N.W.); (P.N.)
| | - Fabian C. Laqua
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Raemistrasse 100, 8091 Zurich, Switzerland; (F.C.L.); (B.B.)
| | - Bettina Baessler
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Raemistrasse 100, 8091 Zurich, Switzerland; (F.C.L.); (B.B.)
| | - Maximilian C. Kriegmair
- Department of Urology and Urological Surgery, University Medical Center Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany; (J.M.); (L.E.); (K.-F.K.); (M.T.W.); (N.W.); (P.N.)
- Correspondence:
| |
Collapse
|