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Predicting Renal Cell Carcinoma Subtypes and Fuhrman Grading Using Multiphasic CT-Based Texture Analysis and Machine
Amit Gupta1, Sanil Garg1, Neel Yadav1
1Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India.
The Indian Journal of Radiology & Imaging
|April 29, 2025
Summary
Computed tomography texture analysis (CTTA) effectively distinguishes clear cell renal cell carcinoma (ccRCC) from other kidney cancers. This method, using open-source Python, also shows promise in predicting ccRCC tumor grade.
Area of Science:
- Radiology
- Medical Imaging
- Computational Pathology
Background:
- Clear cell renal cell carcinoma (ccRCC) is the most common subtype of kidney cancer.
- Accurate differentiation of ccRCC from non-ccRCC and grading are crucial for treatment planning.
- Current diagnostic methods may have limitations in precise classification and grading.
Purpose of the Study:
- To evaluate computed tomography texture analysis (CTTA) for differentiating ccRCC from non-ccRCC.
- To assess CTTA's ability to predict Fuhrman's grade in ccRCC.
- To utilize open-source Python libraries for these analyses.
Main Methods:
- Retrospective analysis of 144 patients with renal cell carcinoma (RCC).
- Multiphase CT scans analyzed using first- and second-order texture features computed with Python libraries (scipy, numpy, opencv).
- Machine learning models, including Support Vector Machine (SVM), applied for classification and prediction, with external validation.
Main Results:
- Entropy in the corticomedullary (CM) phase showed the best performance for ccRCC vs. non-ccRCC classification (F1 score: 0.83).
- An SVM model using CM phase features achieved the highest F1 score (0.87) for ccRCC differentiation, with external validation yielding 0.82 accuracy and 0.81 F1 score.
- Classification of ccRCC grades (low vs. high) showed lower accuracy, with a maximum F1 score of 0.76 for the CM phase SVM model.
Conclusions:
- CTTA using open-source Python tools is a valuable method for distinguishing ccRCC from non-ccRCC.
- CTTA demonstrates potential for predicting ccRCC tumor grade.
- The corticomedullary phase and SVM models are particularly effective for ccRCC classification.

