CT-Based Texture Analysis in Indeterminate Pediatric Renal and Pararenal Masses

Area of Science:

• Radiology
• Oncology
• Medical Imaging

Background:

• Distinguishing pediatric Wilms tumor from neuroblastoma using conventional CT is challenging, particularly for large tumors.
• Accurate differentiation is crucial for appropriate treatment planning and patient outcomes.

Purpose of the Study:

• To evaluate the efficacy of CT-based texture analysis (CTTA) in differentiating pediatric Wilms tumor from neuroblastoma.
• To assess CTTA's ability to differentiate between histological subtypes of neuroblastoma, including MYCN-amplified cases.

Main Methods:

• Retrospective analysis of contrast-enhanced CT scans from treatment-naive pediatric patients (<18 years) with renal/pararenal tumors.
• Application of texture analysis software to extract first-order texture features (mean, variance, skewness, kurtosis) and grayscale features.
• Statistical analysis using Mann-Whitney U and Fisher's exact tests, with p < 0.05 considered significant.

Main Results:

• Neuroblastoma tumors were more frequently associated with calcifications and metastasis compared to Wilms tumors.
• Neuroblastoma exhibited significantly higher intralesional variance than Wilms tumor.
• MYCN-amplified neuroblastomas showed higher intralesional mean values than unamplified tumors (p < 0.05).

Conclusions:

• CTTA demonstrates potential in differentiating pediatric Wilms tumor from neuroblastoma.
• CTTA may aid in distinguishing between neuroblastoma histological subtypes and identifying MYCN-amplified neuroblastoma.