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CC BY-NC-ND 4.0 · Indian J Radiol Imaging
DOI: 10.1055/s-0045-1808089
Original Article

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

Authors

  • Stuti Chandola 

    1   Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India

  • Priyanka Naranje

    1   Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India

  • Arun Kumar Gupta

    1   Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India

  • Aanchal Kakkar

    2   Department of Pathology, All India Institute of Medical Sciences, New Delhi, India

  • Venkat Iyer

    2   Department of Pathology, All India Institute of Medical Sciences, New Delhi, India

  • Maroof Ahmad Khan

    3   Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India

  • Manisha Jana

    1   Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India

Funding None.
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Abstract

Background

Differentiation between pediatric Wilms tumor and neuroblastoma may be difficult when solely based on conventional computed tomography (CT) features, especially in large tumors.

Objective

This article analyzes the role of CT-based texture analysis (CTTA) in differentiating (1) pediatric Wilms tumor and neuroblastoma and (2) between histological and MYCN amplified subtypes of neuroblastoma.

Materials and Methods

Treatment-naive cases of pediatric (< 18 years) renal/pararenal tumors who underwent a single-phase contrast-enhanced CT of chest, abdomen, and pelvis for staging and preoperative evaluation purposes were enrolled. CT images were processed with texture analysis software for first-order texture features. Calculated parameters included mean, variance, skewness, and kurtosis. Grayscale features were also analyzed among the tumor groups and subgroups. Mann–Whitney U and Fisher's exact tests were used for statistical analysis. A p-value of < 0.05 was considered significant.

Observations and Results

A total of 37 lesions (22 neuroblastoma, 15 Wilms) were evaluated. With respect to grayscale features, neuroblastoma tumors exhibited calcifications in greater frequency with a higher propensity for nodal and visceral metastasis. Significant differences were observed when comparing variance of the two tumor groups with neuroblastoma showing higher intralesional variance values than Wilms tumor. Undifferentiated subtype of neuroblastoma demonstrated higher intralesional variance than other two subtypes combined; MYCN amplified tumors showed higher intralesional mean value than unamplified tumors (p < 0.05 for both). The various neuroblastoma subgroups did not significantly differ when considering the grayscale parameters.

Conclusion

CTTA has a potential role in allowing differentiation between neuroblastoma and Wilms tumor. It may additionally allow differentiation among various histological subtypes of neuroblastoma and detection of MYCN amplified neuroblastoma.

Keywords

texture analysis in CT - pediatric renal masses - Wilms tumor - neuroblastoma

Data Availability Statement

Data can be made available on a reasonable request to the corresponding author.


Authors' Contributions

S.C. collected data, carried out the initial analyses, and drafted the initial manuscript.

M.J. and P.N. conceptualized and designed the study, coordinated and supervised data collection, and critically reviewed and revised the manuscript.

A.G. conceptualized and designed the study, critically reviewed and revised the manuscript for important intellectual content.

A.K. and V.I. supervised the pathological data, critically reviewed and revised the manuscript.

M.A.K. performed the statistical analysis.

All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.


Ethical Approval

This prospective observational study was conducted after obtaining the clearance from the institutional ethics committee (IEC No-598/03.07/2020, RP- 39/2020).


Patients' Consent

A written informed consent was obtained for all the patients and guardians after explaining the procedure in their vernacular language.




Publikationsverlauf

Artikel online veröffentlicht:
04. Juni 2025

© 2025. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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