BMC nephrology · 2026
Associations between CT radiomics analyses and kidney biopsy in patients with kidney disease.
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Hassan Jacob Jalil, Baalmann Fabian, Leonhardi Jakob, Denecke Timm, Lindner Tom H, Scheuermann Uwe, Amann Kerstin, Zimmermann Silke, de Fallois Jonathan, Meyer Hans-Jonas
Аннотация
BACKGROUND: Kidney disease is characterized by microstructural alterations that currently require invasive biopsy for definitive assessment. However, it remains unclear to what extent radiomics features extracted from contrast-enhanced CT can non-invasively reflect kidney function and histopathological changes.
METHODS: Between October 2020 and May 2025 all patients undergoing kidney biopsies and having CT scans prior to biopsy were retrospectively analyzed. A total of 49 patients (59% female, median age 60 years) were included. Of the included patients, 35 biopsies were performed in native kidneys (71%) and 14 in kidney allografts (29%). Contrast-enhanced CT images were used to extract radiomics parameters of the kidney. Kidney segmentation was performed using TotalSegmentator and radiomics feature extraction was conducted with PyRadiomics.
RESULTS: Several associations were identified between the extracted radiomics features and kidney function as well as kidney tissue alterations. For the eGFR (CKD-EPI) the highest association was found for the radiomics feature Energy, which is a measurement of the intensity uniformity (ρ = 0.51, p < 0.001), while the first-order feature 90th Percentile showed the best performance in discriminating patients above and below an eGFR threshold of 15 mL/min/1.73 m² with an AUC of 0.83 (95% CI: 0.67-0.98, p = 0.001). Busyness correlated negatively with glomerulosclerosis (ρ = -0.38, p = 0.007), and Coarseness was positively associated with interstitial inflammation (ρ = 0.37, p = 0.008).
CONCLUSIONS: CT radiomics features are associated with kidney function as well as histopathological alterations observed in kidney biopsies. Further validation is needed in future studies.
METHODS: Between October 2020 and May 2025 all patients undergoing kidney biopsies and having CT scans prior to biopsy were retrospectively analyzed. A total of 49 patients (59% female, median age 60 years) were included. Of the included patients, 35 biopsies were performed in native kidneys (71%) and 14 in kidney allografts (29%). Contrast-enhanced CT images were used to extract radiomics parameters of the kidney. Kidney segmentation was performed using TotalSegmentator and radiomics feature extraction was conducted with PyRadiomics.
RESULTS: Several associations were identified between the extracted radiomics features and kidney function as well as kidney tissue alterations. For the eGFR (CKD-EPI) the highest association was found for the radiomics feature Energy, which is a measurement of the intensity uniformity (ρ = 0.51, p < 0.001), while the first-order feature 90th Percentile showed the best performance in discriminating patients above and below an eGFR threshold of 15 mL/min/1.73 m² with an AUC of 0.83 (95% CI: 0.67-0.98, p = 0.001). Busyness correlated negatively with glomerulosclerosis (ρ = -0.38, p = 0.007), and Coarseness was positively associated with interstitial inflammation (ρ = 0.37, p = 0.008).
CONCLUSIONS: CT radiomics features are associated with kidney function as well as histopathological alterations observed in kidney biopsies. Further validation is needed in future studies.