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Objectives: To investigate different radiomics models based on single phase and the different phase combinations of radiomics features from 3D tri-phasic CT to distinguish RO from chRCC. Methods: A total of 96 patients (30 RO and 66 chRCC) were enrolled in this study. Radiomics features were extracted from unenhanced phase (UP), corticomedullary phase (CMP), and nephrographic phase (NP) CT images. Feature selection was based on the least absolute shrinkage and selection operator regression (LASSO) method. The selected features were used to develop different radiomics models using logistic regression (LR) analysis, including model 1 (UP), model 2(CMP), model 3(NP), model 4(UP+CMP), model 5(UP+NP), model 6(CMP+NP), and model 7(UP+CMP+NP). The radiomics model demonstrating the highest discrimination performance was utilized to construct the combined model (model 8) with clinical factors. A nomogram based on the model 8 was established. To evaluate the diagnostic performance of the different models, the receiver operating characteristic (ROC) curve and decision curve analysis (DCA) were used. Delong's test was utilized to assess the statistical significance of the AUC improvement across the models. Results: Among the seven radiomics models, model 7 exhibited the highest AUC of 0.84 (95% CI 0.69, 0.99), and model 7 demonstrated a significantly superior AUC compared to the other radiomics models (all P < 0.05). The AUC values of radiomics models based on two phases (model4, mode5, mode6) were greater than the models based on single phase (model1, mode2, mode3) (all P < 0.05). Model 3 illustrated the best performance of the three radiomics models based on single phase with an AUC of 0.76 (95% CI 0.57, 099). Model 6 illustrated the best performance of the three radiomics models based on two-phases combination with an AUC of 0.83 (0.66, 0.99). Model 8 achieved an AUC of 0.93 (95% CI 0.83, 1.00) which is higher than those all radiomics models. Conclusion: Radiomics models based on combination of radiomics features from UP, CMP, and NP can be a useful and promising technique to differentiate RO from chRCC. Moreover, the model combining clinical factors and radiomics features showed better classification performance to distinguish them. [ABSTRACT FROM AUTHOR]

Oncocytomas are referred to as benign kidney neoplasms. They primarily affect adults, with patients over 70 years old being the most affected. Renal oncocytomas (ROs) are frequently detected by excision, biopsy, or scan. Hematuria, flank pain, and a palpable mass are the traditional trio of symptoms. Oncocytomas appear as well-circumscribed, tan or mahogany-coloured masses with a central scar that is stellate. Histological features include well-circumscribed lesions, bland cytology, eosinophilic cytoplasm, regular nuclei with prominent central nucleoli, and nested architecture. ROs are rarely linked to an aggressive clinical course and have an excellent prognosis. There is proof that the disease can spread to the liver and bones. Some literature has also reported oncocytoma metastases to the lung and liver. This systematic review of the literature examines and evaluates the malignant potential of oncocytoma. The purpose of the study was to determine whether ROs can be diagnosed as a benign condition or if malignancy needs to be considered and investigated. Seventeen studies were analysed which had a total of 412 ROs. Four patients (one percent) died as a result of their illness. There was evidence of disease progression in every patient who passed away from their illness. Six patients (1.5%) experienced disease progression in total. Three hundred and seventeen patients (80%) underwent radical nephrectomy, while 81 patients (20%) underwent partial nephrectomy. Liver, bone, lung, lymphadenopathy, and local recurrence were among the metastasis sites. Perinephric fat invasion, renal sinus fat invasion, renal capsular invasion, and vascular invasion are characteristics of metastatic behavior that have been found. Despite this, the small number of patients who experienced disease progression and/or death as a result of ROs implies that aggressive malignant behavior is not always correlated with the presence of metastatic features or disease. Oncocytomas should be viewed as having a low potential for malignancy rather than as benign. Individuals who exhibit aggressive characteristics, such as vascular invasion and/or perinephric fat invasion, have an atypically good prognosis. Despite advancements in imaging and immunochemical techniques, it is indisputable that ROs, which were first classified as renal tumours in 1976, continue to pose a diagnostic challenge for multidisciplinary teams. There is considerable variation in practice across the globe due to difficulties in confirming ROs, especially when it comes to metastatic disease. There is even more variation in the management of follow-up care that follows. This will remain the MDT's current state until randomised controlled trials, long-term results, and a better comprehension of the behavior of this tumour are obtained., Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Rajagopal et al.)