ArticleCancer imaging : the official publication of the International Cancer Imaging Society2025
Development of modified multi-parametric CT algorithms for diagnosing clear-cell renal cell carcinoma in small solid renal masses.
Article in Cancer imaging : the official publication of the International Cancer Imaging Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed.
- Improving Clear Cell Renal Cell Carcinoma Diagnosis: Modified CT Algorithms with Simplified Heterogeneity Scoring.Annals of surgical oncology · 2026Article
- ASO Author Reflections: Refining CT Heterogeneity Scoring to Improve Clear Cell Renal Cell Carcinoma Diagnosis in Small Renal Masses.Annals of surgical oncology · 2026Article
- Tumor heterogeneity on contrast-enhanced computed tomography outperforms attenuation ratio in differentiating renal cell carcinoma subtypes: a pathologic correlation study.The Pan African medical journal · 2026Article
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9 authors.
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Abstract
objectiveTo refine the existing CT algorithm to enhance inter-reader agreement and improve the diagnostic performance for clear-cell renal cell carcinoma (ccRCC) in solid renal masses less than 4 cm.
methodsA retrospective collection of 331 patients with pathologically confirmed renal masses were enrolled in this study. Two radiologists independently assessed the CT images: in addition to heterogeneity score (HS) and mass-to-cortex corticomedullary attenuation ratio (MCAR), measured parameters included ratio of major diameter to minor diameter at the maximum axial section (Major axis / Minor axis), tumor-renal interface, standardized heterogeneity ratio (SHR), and standardized nephrographic reduction rate (SNRR). Spearman's correlation analysis was performed to evaluate the relationship between SHR and HS. Univariate and multivariate logistic regression analyses were employed to identify independent risk factors and then CT-score was adjusted by those indicators. The diagnostic efficacy of the modified CT-scores was evaluated using ROC curve analysis.
resultsThe SHR and heterogeneity grade (HG) of mass were correlated positively with the HS (R = 0.749, 0.730, all P < 0.001). Logistic regression analysis determined that the Major axis / Minor axis (> 1.16), the tumor-renal interface (> 22.3 mm), and the SNRR (> 0.16) as additional independent risk factors to combine with HS and MCAR. Compared to the original CT-score, the two CT algorithms combined tumor-renal interface and SNRR showed significantly improved diagnostic efficacy for ccRCC (AUC: 0.770 vs. 0.861 and 0.862, all P < 0.001). The inter-observer agreement for HG was higher than that for HS (weighted Kappa coefficient: 0.797 vs. 0.722). The consistency of modified CT-score was also superior to original CT-score (weighted Kappa coefficient: 0.935 vs. 0.878).
conclusionThe modified CT algorithms not only enhanced inter-reader consistency but also improved the diagnostic capability for ccRCC in small renal masses.
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