Quantitative assessment of perirenal fat density in renal cell carcinoma: a combined radiologist-driven and YOLO-based CT study.
Authors
Affiliations (2)
Affiliations (2)
- Department of Radiology, School of Medicine, Tekirdağ Namık Kemal University, Tekirdağ, Türkiye.
- Department of Software Engineering, Faculty of Engineering and Natural Sciences, Bandırma Onyedi Eylül University, Bandırma, Türkiye.
Abstract
To compare perirenal adipose tissue density (PRFD) between patients with renal cell carcinoma (RCC) and healthy controls using non-enhanced computed tomography, and to compare manual measurements and YOLOv8-based machine learning (ML) of PRFD. The study involved 57 patients with confirmed RCC and 82 control subjects. PRFD was measured manually at different levels of the kidneys and other tumor features. The ML analysis utilized specific attenuation intervals to evaluate PRFD and assess agreement with manual measurements. RCC group had significantly lower PRFD values at the upper renal pole compared to controls (right: <i>p</i> = 0.040; left: <i>p</i> = 0.032), while other kidney sections showed no significant differences. In healthy controls, there was a significant right-left difference at all levels, whereas in RCC patients this was seen only at the upper pole (<i>p</i> = 0.005). Tumor size was positively correlated with PRFD in specific regions. Tumor volume categories were significantly associated with the presence of tumoral necrosis (<i>p</i> = 0.003). The ML method generally aligned with manual measurements, but accuracy varied based on the normalization technique used. The study found that PRFD varies between RCC patients and controls, particularly at the upper pole, relating more closely to tumor size than to sex or histological type. As the groups were not age-matched, this difference may partly reflect age rather than disease status. The findings suggest that PRFD could be an important imaging marker for RCC evaluation.