Literature DB >> 30538793

Radiomics improves efficiency for differentiating subclinical pheochromocytoma from lipid-poor adenoma: a predictive, preventive and personalized medical approach in adrenal incidentalomas.

Xiaoping Yi1,2, Xiao Guan3, Youming Zhang1, Longfei Liu3, Xueying Long1, Hongling Yin4, Zhongjie Wang5, Xuejun Li5, Weihua Liao1, Bihong T Chen6, Chishing Zee7.   

Abstract

OBJECTIVES: This study aims to define a radiomic signature for pre-operative differentiation between subclinical pheochromocytoma (sPHEO) and lipid-poor adrenal adenoma (LPA) in adrenal incidentaloma. The goal was to apply a predictive, preventive, and personalized medical approach to the management of adrenal tumors. PATIENTS AND METHODS: This retrospective study consisted of 265 consecutive patients (training cohort, 212 (LPA, 145; sPHEO, 67); validation cohort, 53 (LPA, 36; sPHEO, 17)). Computed tomography (CT) imaging features were evaluated, including long diameter (LD), short diameter (SD), pre-enhanced CT value (CTpre), enhanced CT value (CTpost), shape, homogeneity, necrosis or cystic degeneration (N/C). Radiomic features were extracted and then were used to construct a radiomic signature (Rad-score) and radiomic nomogram. The area under the receiver operating characteristic curve (AUC) was used to evaluate their performance.
RESULTS: Sixteen of three hundred forty candidate features were used to build a radiomic signature. The signature was significantly different between the sPHEO and LPA groups (AUC: training, 0.907; validation, 0.902). The radiomic nomogram based on enhanced CT features (M1) consisted of Rad-score, LD, SD, CTpre, shape, homogeneity and N/C (AUC: training, 0.957; validation, 0.967). The pre-enhanced CT features based radiomic nomogram (M2) included Rad-score, LD, SD, CTpre, shape, and homogeneity (AUC: training, 0.955; validation, 0.958).
CONCLUSIONS: Our radiomic nomograms based on pre-enhanced and enhanced CT images distinguished sPHEO from LPA. In addition, the promising result using pre-enhanced CT images for predictive diagnostics is important because patients could avoid the additional radiation and risk associated with enhanced CT.

Entities:  

Keywords:  Adrenal adenoma; Adrenal gland neoplasms; Computed tomography; Pheochromocytoma; Predictive preventive personalized medicine; Radiomics

Year:  2018        PMID: 30538793      PMCID: PMC6261906          DOI: 10.1007/s13167-018-0149-3

Source DB:  PubMed          Journal:  EPMA J        ISSN: 1878-5077            Impact factor:   6.543


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