Journal of Southern Medical University

Journal of Southern Medical University ›› 2023, Vol. 43 ›› Issue (5): 800-806.doi: 10.12122/j.issn.1673-4254.2023.05.16

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Comparison of diagnostic performance of Clear Cell Likelihood Score v1.0 and v2.0 for clear renal cell carcinoma

HAO Yuwei, GAO Sheng, ZHANG Xiaoyue, CUI Mengqiu, DING Xiaohui, WANG He, YANG Dawei, YE Huiyi, WANG Haiyi   

  1. Medical School of Chinese PLA, Beijing 100853, China; Department of Radiology, Department of Pathology, First Medical Center of Chinese PLA General Hospital, Beijing 100853, China; Department of Radiology, Linyi Central Hospital, Linyi 276400, China; Department of Radiology, First Hospital of Shanxi Medical University, Taiyuan 030012, China; Department of Radiology, Peking University First Hospital, Beijing 100035, China; Department of Radiology, Beijing Friendship Hospital, Beijing 100050, China
  • Online:2023-05-20 Published:2023-06-12

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Abstract: Objective To compare the performance of Clear Cell Likelihood Score (ccLS) v1.0 and v2.0 in diagnosing clear cell renal cell carcinoma (ccRCC) from small renal masses (SRM). Methods We retrospectively analyzed the clinical data and MR images of patients with pathologically confirmed solid SRM from the First Medical Center of the Chinese PLA General Hospital between January 1, 2018, and December 31, 2021, and from Beijing Friendship Hospital of Capital Medical University and Peking University First Hospital between January 1, 2019 and May 17, 2021. Six abdominal radiologists were trained for use of the ccLS algorithm and scored independently using ccLS v1.0 and ccLS v2.0. Random- effects logistic regression modeling was used to generate plot receiver operating characteristic curves (ROC) to evaluate the diagnostic performance of ccLS v1.0 and ccLS v2.0 for ccRCC, and the area under curve (AUC) of these two scoring systems were compared using the DeLong's test. Weighted Kappa test was used to evaluate the interobserver agreement of the ccLS score, and differences in the weighted Kappa coefficients was compared using the Gwet consistency coefficient. Results In total, 691 patients (491 males, 200 females; mean age, 54 ± 12 years) with 700 renal masses were included in this study. The pooled accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of ccLS v1.0 for diagnosing ccRCC were 77.1%, 76.8%, 77.7%, 90.2%, and 55.7%, as compared with 80.9%, 79.3%, 85.1%, 93.4%, 60.6% with ccLS v2.0, respectively. The AUC of ccLS v2.0 was significantly higher than that of ccLS v1.0 for diagnosis of ccRCC (0.897 vs 0.859; P<0.01). The interobserver agreement did not differ significantly between ccLS v1.0 and ccLS v2.0 (0.56 vs 0.60; P>0.05). Conclusion ccLS v2.0 has better performance for diagnosing ccRCC than ccLS v1.0 and can be considered for use to assist radiologists with their routine diagnostic tasks.

Key words: multi-parameter magnetic resonance imaging, small renal masses, Clear Cell Likelihood Score, clear cell renal cell carcinoma