Artificial intelligence-based non-invasive tumor segmentation, grade stratification and prognosis prediction for clear-cell renal-cell carcinoma

Siteng Chen, Dandan Song, Lei Chen, Tuanjie Guo, Beibei Jiang, Aie Liu, Xianpan Pan, Tao Wang, Heting Tang, Guihua Chen, Zhong Xue, Xiang Wang*, Ning Zhang*, Junhua Zheng*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Due to the complicated histopathological characteristics of clear-cell renal-cell carcinoma (ccRCC), non-invasive prognosis before operative treatment is crucial in selecting the appropriate treatment. A total of 126 345 computerized tomography (CT) images from four independent patient cohorts were included for analysis in this study. We propose a V Bottleneck multi-resolution and focus-organ network (VB-MrFo-Net) using a cascade framework for deep learning analysis. The VB-MrFo-Net achieved better performance than VB-Net in tumor segmentation, with a Dice score of 0.87. The nuclear-grade prediction model performed best in the logistic regression classifier, with area under curve values from 0.782 to 0.746. Survival analysis revealed that our prediction model could significantly distinguish patients with high survival risk, with a hazard ratio (HR) of 2.49 [95% confidence interval (CI): 1.13-5.45, P = 0.023] in the General cohort. Excellent performance had also been verified in the Cancer Genome Atlas cohort, the Clinical Proteomic Tumor Analysis Consortium cohort, and the Kidney Tumor Segmentation Challenge cohort, with HRs of 2.77 (95%CI: 1.58-4.84, P = 0.0019), 3.83 (95%CI: 1.22-11.96, P = 0.029), and 2.80 (95%CI: 1.05-7.47, P = 0.025), respectively. In conclusion, we propose a novel VB-MrFo-Net for the renal tumor segmentation and automatic diagnosis of ccRCC. The risk stratification model could accurately distinguish patients with high tumor grade and high survival risk based on non-invasive CT images before surgical treatments, which could provide practical advice for deciding treatment options.

Original languageEnglish
Article numberpbad019
JournalPrecision Clinical Medicine
Volume6
Issue number3
DOIs
Publication statusPublished - Sept 2023

Bibliographical note

Funding Information:
This study was supported by the National Natural Science Foundation of China (Grants No. 81972393 and 82002665). We appreciate partial data support from the National Cancer Institute Clinical Proteomic Tumor Analysis Consortium, the Cancer Genome Atlas, and the Cancer Imaging Archive.

Publisher Copyright:
© 2023 The Author(s). Published by Oxford University Press on behalf of the West China School of Medicine & West China Hospital of Sichuan University.

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