<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE root>
<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="other" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">Digital Diagnostics</journal-id><journal-title-group><journal-title xml:lang="en">Digital Diagnostics</journal-title><trans-title-group xml:lang="ru"><trans-title>Digital Diagnostics</trans-title></trans-title-group><trans-title-group xml:lang="zh"><trans-title>Digital Diagnostics</trans-title></trans-title-group></journal-title-group><issn publication-format="print">2712-8490</issn><issn publication-format="electronic">2712-8962</issn><publisher><publisher-name xml:lang="en">Eco-Vector</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">693796</article-id><article-id pub-id-type="doi">10.17816/DD693796</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>Reviews</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>Научные обзоры</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="zh"><subject>科学评论</subject></subj-group><subj-group subj-group-type="article-type"><subject>Unknown</subject></subj-group></article-categories><title-group><article-title xml:lang="en">The potential of Radiomics for the differential diagnosis of faat-poor angiomyolipomas and other renal tumors: a Rewiev</article-title><trans-title-group xml:lang="ru"><trans-title>Возможности применения радиомики с целью дифференциальной диагностики ангиомиолипом с низким содержанием жира и других опухолей почек: обзор.</trans-title></trans-title-group><trans-title-group xml:lang="zh"><trans-title/></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0007-9567-3513</contrib-id><contrib-id contrib-id-type="spin">4907-7740</contrib-id><name-alternatives><name xml:lang="en"><surname>Zolotova</surname><given-names>Daria E.</given-names></name><name xml:lang="ru"><surname>Золотова</surname><given-names>Дарья Евгеньевна</given-names></name><name xml:lang="zh"><surname></surname><given-names></given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="ru"><p>Аспирант кафедры лучевой диагностики и терапии Факультета Фундаментальной</p>
<p>Медицины МНОИ МГУ им. М.В.Ломоносова.</p>
<p> </p>
<p>Врач отделения рентгенодиагностики с кабинетами МРТ и КТ Университетской клиники.</p></bio><email>darachich@yandex.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-1266-4926</contrib-id><contrib-id contrib-id-type="spin">6897-9641</contrib-id><name-alternatives><name xml:lang="en"><surname>Mershina</surname><given-names>Elena A.</given-names></name><name xml:lang="ru"><surname>Мершина</surname><given-names>Елена Александровна</given-names></name><name xml:lang="zh"><surname>Mershina</surname><given-names>Elena A.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, Cand. Sci. (Med), Associate Professor</p></bio><bio xml:lang="ru"><p>канд. мед. наук, доцент</p></bio><bio xml:lang="zh"><p>MD, Cand. Sci. (Med), Associate Professor</p></bio><email>elena_mershina@mail.ru</email><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-9127-7539</contrib-id><contrib-id contrib-id-type="spin">9668-2229</contrib-id><name-alternatives><name xml:lang="en"><surname>Makovskaya</surname><given-names>Lyudmila Andrianovna</given-names></name><name xml:lang="ru"><surname>Маковская</surname><given-names>Людмила Андрияновна</given-names></name><name xml:lang="zh"><surname></surname><given-names></given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="ru"><p>Врач отделения рентгенодиагностики с кабинетами МРТ и КТ Университетской клиники.</p></bio><email>l.a.makovskaya@yandex.ru</email><xref ref-type="aff" rid="aff1"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">Lomonosov Moscow State University, Medical Research and Educational Institute (MREI MSU), Faculty of Fundamental Medicine</institution></aff><aff><institution xml:lang="ru">Московский государственный университет имени М.В. Ломоносова, Медицинский научно-образовательный институт (МНОИ МГУ)                                                                       Факультет фундаментальной медицины МНОИ МГУ</institution></aff><aff><institution xml:lang="zh"></institution></aff></aff-alternatives><aff-alternatives id="aff2"><aff><institution xml:lang="en">Lomonosov Moscow State University, Medical Research and Educational Institute (MREI MSU), Faculty of Fundamental Medicine</institution></aff><aff><institution xml:lang="ru">Московский государственный университет имени М.В. Ломоносова, Медицинский научно-образовательный институт (МНОИ МГУ)                                                                       Факультет фундаментальной медицины МНОИ МГУ</institution></aff><aff><institution xml:lang="zh">Lomonosov Moscow State University, Medical Research and Educational Institute (MREI MSU), Faculty of Fundamental Medicine</institution></aff></aff-alternatives><pub-date date-type="preprint" iso-8601-date="2026-06-29" publication-format="electronic"><day>29</day><month>06</month><year>2026</year></pub-date><volume>7</volume><issue>2</issue><issue-title xml:lang="ru"/><history><date date-type="received" iso-8601-date="2025-10-19"><day>19</day><month>10</month><year>2025</year></date><date date-type="accepted" iso-8601-date="2026-05-12"><day>12</day><month>05</month><year>2026</year></date></history><permissions><copyright-statement xml:lang="en">Copyright ©; , Eco-Vector</copyright-statement><copyright-statement xml:lang="ru">Copyright ©; , Эко-вектор</copyright-statement><copyright-statement xml:lang="zh">Copyright ©; , Eco-Vector</copyright-statement><copyright-holder xml:lang="en">Eco-Vector</copyright-holder><copyright-holder xml:lang="ru">Эко-вектор</copyright-holder><copyright-holder xml:lang="zh">Eco-Vector</copyright-holder><ali:free_to_read xmlns:ali="http://www.niso.org/schemas/ali/1.0/"/><license><ali:license_ref xmlns:ali="http://www.niso.org/schemas/ali/1.0/">https://creativecommons.org/licenses/by-nc-nd/4.0</ali:license_ref></license></permissions><self-uri xlink:href="https://jdigitaldiagnostics.com/DD/article/view/693796">https://jdigitaldiagnostics.com/DD/article/view/693796</self-uri><abstract xml:lang="en"><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p><p>Over the past decades, the detection rate of kidney tumors has increased. However, some of them may be benign. Radiographic diagnostic methods are often unable to reliably determine the tumor's nature, so histological verification remains the gold standard. The use of noninvasive methods for diagnosing tumors is particularly relevant in modern urology. One such promising method is radiomics, which is based on mathematical methods for assessing tumor structure heterogeneity and allows for the prediction of histological verification results. Nevertheless, the lack of standardization and external validation of modern radiomics methods hinders their widespread implementation. Over the past few years, radiomics analysis has increasingly been used in conjunction with machine learning (ML) methods, which reduce the risk of systematic errors.</p> <p>This paper presents a review of publications devoted to MR and CT radiomics in differentiating fat-poor AML from other types of kidney tumors with low lipid content. It provides information on the role of radiomics in determining the nature of kidney tumors, details the methodology for performing radiomics analysis, and demonstrates the results of radiomics analysis for the differential diagnosis of fat-poor AML from other renal tumors based on CT and MR images, identifying the most reliable textural features.</p> <p>A search of publications using keywords in the Russian scientific database <ext-link ext-link-type="uri" xlink:href="https://elibrary.ru/">eLIBRARY.RU</ext-link> yielded no results. Therefore, a search of English-language literature was conducted using PubMed/MEDLINE, Embase, and the ClinicalTrials.gov registry, published between January 2021 and 2025, which used MR and CT radiomics to differentiate BG-AML from other renal tumors. A total of 791 articles were initially identified. After applying eligibility criteria and excluding duplicate publications, nine articles were included in the review.</p> <p> Each study included in the review demonstrated high AUC values ​​for the predictive model. The combination of radiomics with clinical and/or conventional imaging features outperformed both clinical and radiomics only models. Second-order features (GLCM, GLRLM, GLSZM, GLDM, NGTDM) were identified as statistically significant in 67% of cases. Machine learning methods were used in every study. Logistic regression was the most common machine learning algorithm (7/9 studies). Radiomics features were extracted from CT images in 6/9 studies, while MRI-based radiomics was used in three studies. Most studies (6/9) focused on differentiating fp-AML from clear cell renal cell carcinoma.</p> <p>The quality of the studies, assessed based on their methodology, was considered satisfactory. This was primarily due to the lack of external validation of results (89% of the included articles), as well as the unavailability or opacity of data (82%). It is essential to highlight that there is no strict standardization in radiomics analysis. Some authors used 2D segmentation (in 5/9 studies) and manual region of interest (ROI) delineation in most studies. Thus, the reproducibility of radiomics parameters can be considered low. All included studies were retrospective, corresponding to the current state of radiomics research. Differentiating fp-AML remains challenging due to its low prevalence, which leads to small sample sizes and class imbalance.</p> <p>Therefore, strict standardization and the creation of an open radiomics database are necessary for the implementation of radiomics in clinical practice. The use of machine translation algorithms in radiomics can lead to increased sensitivity, specificity, and accuracy in distinguishing renal masses. Further prospective multicenter studies with external validation are needed to introduce radiomics into clinical practice.</p>              <p> </p></abstract><trans-abstract xml:lang="ru"><p>За последние десятилетия выявляемость опухолей почки возросла. Однако, часть из них, особенно на стадии T1а, может иметь доброкачественную природу. Методы лучевой диагностики зачастую не способны достоверно судить о природе опухоли, поэтому гистологическая верификация остаётся золотым стандартом. Использование неинвазивных методов диагностики природы опухолей является особенно актуальным для современной урологии. Одним из подобных перспективных методов является радиомика, основанная на математических методах оценки неоднородности структуры опухолей и позволяющая прогнозировать результаты гистологической верификации. Однако, отсутствие стандартизации и внешней валидации современных методов радиомики не позволяет широко их внедрять. За последние несколько лет радиомический анализ стал всё чаще использоваться в совокупности с методами машинного обучения (МО), позволяющими снижать риск систематических ошибок.</p> <p>В данной работе представлен обзор публикаций посвященных МР- и КТ-радиомике в дифференциации БЖ-АМЛ от других видов опухолей почек с низким содержанием жира.</p> <p>В статье<bold> </bold>предоставлены сведения<bold> </bold>о роли радиомики в определении природы опухолей почек, подробные данные о методологии выполнения радиомического анализа, продемонстрированы результаты радиомического анализа для дифференциальной диагностики БЖ-АМЛ от остальных почечных опухолей на основе КТ- и МР-изображений с указанием наиболее надежных текстурных признаков.</p> <p>Поиск русскоязычных публикаций на основе российской научной базы <ext-link ext-link-type="uri" xlink:href="https://elibrary.ru/"><bold>elibrary.ru</bold></ext-link> с помощью ключевых слов не дал результатов. Поэтому был проведён поиск англоязычной литературы с использованием баз данных PubMed/MEDLINE, Embase и реестра <ext-link ext-link-type="uri" xlink:href="https://clinicaltrials.gov/">ClinicalTrials.gov</ext-link>, опубликованной в период с января 2021 по 2025год, в которой использовалась МР- и КТ-радиомика для дифференциации между БЖ-АМЛ и другими почечными опухолями. Первоначально была отобрана 791 статья. После применения критериев соответствия и исключения дублирующий публикаций в обзор были включены 9 статей.</p> <p>Каждое вошедшее в обзор исследование продемонстрировало высокие показатели AUC для предсказательной модели. Признаки второго порядка были выделены в 67% случаев как статистически значимые. В каждой работе применялись методы МО. Качество исследований, которое оценивали по данным их методологии, было признано удовлетворительным. В основном его снижение было обусловлено отсутствием внешней валидации результатов (89% проанализированных статей), а также недоступностью или непрозрачностью данных (82%). Воспроизводимость радиомических параметров можно считать низкой.</p> <p>Таким образом<bold> </bold>для внедрения радиомики в клиническую практику необходимы строгая стандартизация и создание открытой базы радиомических данных. Применение алгоритмов МО в радиомике может привести к повышению чувствительности, специфичности и точности в различении почечных образований.</p></trans-abstract><trans-abstract xml:lang="zh"><p/></trans-abstract><kwd-group xml:lang="en"><kwd>radiomics</kwd><kwd>angiomyolipoma</kwd><kwd>tomography, spiral computed</kwd><kwd>machine learning</kwd><kwd>review.</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>радиомика</kwd><kwd>ангиомиолипома</kwd><kwd>томография компьютерная спиральная</kwd><kwd>машинное обучение</kwd><kwd>обзор.</kwd></kwd-group><funding-group/></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><mixed-citation>[1] Sebastià C, Corominas D, Musquera M, et al. Active surveillance of small renal masses. Insights Imaging. 2020;11(1):63. doi:10.1186/s13244-020-00853-y</mixed-citation></ref><ref id="B2"><label>2.</label><mixed-citation>[2] Trovato P, Simonetti I, Morrone A, et al. Scientific status quo of small renal lesions: diagnostic assessment and radiomics. J Clin Med. 2024;13(2):547. doi:10.3390/jcm13020547</mixed-citation></ref><ref id="B3"><label>3.</label><mixed-citation>[3] Silvestri A, Gavi F, Sighinolfi MC, et al. Management of small renal masses: literature and guidelines review. Int Braz J Urol. 2025;51(5):e20250203. doi:10.1590/S1677-5538.IBJU.2025.0203</mixed-citation></ref><ref id="B4"><label>4.</label><mixed-citation>[4] Ma Y, Xu X, Pang P, et al. A CT-based tumoral and mini-peritumoral radiomics approach: differentiate fat-poor angiomyolipoma from clear cell renal cell carcinoma. Cancer Manag Res. 2021;13:1417-1425. doi:10.2147/CMAR.S297094</mixed-citation></ref><ref id="B5"><label>5.</label><mixed-citation>[5] Feng S, Gong M, Zhou D, et al. A CT-based radiomics nomogram for differentiation of benign and malignant small renal masses (≤4 cm). Transl Oncol. 2023;29:101627. doi:10.1016/j.tranon.2023.101627</mixed-citation></ref><ref id="B6"><label>6.</label><mixed-citation>[6] Uhlig J, Biggemann L, Nietert MM, et al. Discriminating malignant and benign clinical T1 renal masses on computed tomography: a pragmatic radiomics and machine learning approach. Medicine (Baltimore). 2020;99(16):e19725. doi:10.1097/MD.0000000000019725</mixed-citation></ref><ref id="B7"><label>7.</label><mixed-citation>[7] Ferro M, Crocetto F, Barone B, et al. Artificial intelligence and radiomics in evaluation of kidney lesions: a comprehensive literature review. Ther Adv Urol. 2023;15:1-26. doi:10.1177/17562872231164803</mixed-citation></ref><ref id="B8"><label>8.</label><mixed-citation>[8] Kocak B, Kaya OK, Erdim C, et al. Artificial intelligence in renal mass characterization: a systematic review of methodologic items related to modeling, performance evaluation, clinical utility, and transparency. AJR Am J Roentgenol. 2020;215(5):1113-1122. doi:10.2214/AJR.20.22847</mixed-citation></ref><ref id="B9"><label>9.</label><mixed-citation>[9] Ma Y, Ma W, Xu X, et al. A convention-radiomics CT nomogram for differentiating fat-poor angiomyolipoma from clear cell renal cell carcinoma. Sci Rep. 2021;11(1):4644. doi:10.1038/s41598-021-84244-3</mixed-citation></ref><ref id="B10"><label>10.</label><mixed-citation>[10] Han Z, Zhu Y, Xu J, et al. Predictive value of CT-based radiomics in distinguishing renal angiomyolipomas with minimal fat from other renal tumors. Dis Markers. 2022;2022:9108129. doi:10.1155/2022/9108129</mixed-citation></ref><ref id="B11"><label>11.</label><mixed-citation>[11] Kim TM, Ahn H, Lee HJ, et al. Differentiating renal epithelioid angiomyolipoma from clear cell carcinoma: using a radiomics model combined with CT imaging characteristics. Abdom Radiol. 2022;47(8):2867-2880. doi:10.1007/s00261-022-03571-9</mixed-citation></ref><ref id="B12"><label>12.</label><mixed-citation>[12] Matsumoto S, Arita Y, Yoshida S, et al. Utility of radiomics features of diffusion-weighted magnetic resonance imaging for differentiation of fat-poor angiomyolipoma from clear cell renal cell carcinoma: model development and external validation. Abdom Radiol. 2022;47(6):2178-2186. doi:10.1007/s00261-022-03486-5</mixed-citation></ref><ref id="B13"><label>13.</label><mixed-citation>[13] Jian L, Liu Y, Xie Y, et al. MRI-based radiomics and urine creatinine for the differentiation of renal angiomyolipoma with minimal fat from renal cell carcinoma: a preliminary study. Front Oncol. 2022;12:876664. doi:10.3389/fonc.2022.876664</mixed-citation></ref><ref id="B14"><label>14.</label><mixed-citation>[14] Chai S., Yang Y., Ma C., Ma Z. A MRI-based radiomics nomogram for differentiation of fat-poor renal angiomyolipoma from nodular clear cell renal cell carcinoma. Research Square; 2024. 19 p. (Preprint No. rs-4121605/v1). doi:10.21203/rs.3.rs-4121605/v1</mixed-citation></ref><ref id="B15"><label>15.</label><mixed-citation>[15] Wei J, Ma Y, Liu J, et al. A noninvasive comprehensive model based on medium sample size had good diagnostic performance in distinguishing renal fat-poor angiomyolipoma from homogeneous clear cell renal cell carcinoma. Urol Oncol. 2025;43(5):332.e1-332.e10. doi:10.1016/j.urolonc.2024.11.013</mixed-citation></ref><ref id="B16"><label>16.</label><mixed-citation>[16] Bang S, Wang H, Bae H, et al. Computed tomography-based radiomics diagnostic model for fat-poor small renal tumor subtypes. Diagnostics. 2025;15(11):1365. doi:10.3390/diagnostics15111365</mixed-citation></ref><ref id="B17"><label>17.</label><mixed-citation>[17] van Oostenbrugge TJ, Fütterer JJ, Mulders PFA. Diagnostic imaging for solid renal tumors: a pictorial review. Kidney Cancer. 2018;2(2):79-93. doi:10.3233/KCA-180028</mixed-citation></ref><ref id="B18"><label>18.</label><mixed-citation>[18] Alhussaini AJ, Steele JD, Jawli A, Nabi G. Radiomics machine learning analysis of clear cell renal cell carcinoma for tumour grade prediction based on intra-tumoural sub-region heterogeneity. Cancers. 2024;16(8):1454. doi:10.3390/cancers16081454</mixed-citation></ref><ref id="B19"><label>19.</label><mixed-citation>[19]Dehghani Firouzabadi F, Gopal N, Hasani A, et al. CT radiomics for differentiating fat poor angiomyolipoma from clear cell renal cell carcinoma: systematic review and meta-analysis. PLoS One. 2023;18(7):e0287299. doi:10.1371/journal.pone.0287299</mixed-citation></ref><ref id="B20"><label>20.</label><mixed-citation>[20] Han JH, Kim BW, Kim TM, et al. Fully automated segmentation and classification of renal tumors on CT scans via machine learning. BMC Cancer. 2025;25(1):173. doi:10.1186/s12885-025-13582-6</mixed-citation></ref><ref id="B21"><label>21.</label><mixed-citation>[21] Vasilev YA, Nanova OG, Blokhin IA, et al. Priority radiomic parameters for computed tomography of head and neck malignancies: a systematic review. Digital Diagnostics. 2024;5(2):255-268. doi:10.17816/DD623240; EDN: NPWNFS</mixed-citation></ref></ref-list></back></article>
