Renal Transplant Survival Prediction From Unsupervised Deep Learning-Based Radiomics on Early Dynamic Contrast-Enhanced MRI.
Authors
Affiliations (9)
Affiliations (9)
- MICS, CentraleSupelec, Paris-Saclay University, Inria Saclay, 9 Rue Joliot Curie, 91190 Gif-sur-Yvette, France (L.M., M.V.). Electronic address: [email protected].
- Department of Adult Radiology, Necker Hospital, APHP, 149 Rue de Sèvres, 75015 Paris, France (S.B., A.M.T., J.M.C.).
- LIX, École Polytechnique, CNRS, Institut Polytechnique de Paris, 1 Rue Honoré d'Estienne d'Orves, 91120 Palaiseau, France (V.K.).
- Department of Urology and Renal Transplantation, Georges Pompidou European Hospital, APHP, 20 Rue Leblanc, 75015 Paris, France (F.P., M.O.T.).
- Department of Nephrology and Kidney Transplantation, Necker Hospital, APHP, 149 Rue de Sèvres, 75015 Paris, France (I.B., D.A.).
- Department of Adult Radiology, Necker Hospital, APHP, 149 Rue de Sèvres, 75015 Paris, France (S.B., A.M.T., J.M.C.); UFR Médecine, Paris-Cité University, 15 Rue de l'Ecole de Médecine, 75006 Paris, France (J.M.C., D.A., M.O.T.).
- Department of Nephrology and Kidney Transplantation, Necker Hospital, APHP, 149 Rue de Sèvres, 75015 Paris, France (I.B., D.A.); UFR Médecine, Paris-Cité University, 15 Rue de l'Ecole de Médecine, 75006 Paris, France (J.M.C., D.A., M.O.T.).
- MICS, CentraleSupelec, Paris-Saclay University, Inria Saclay, 9 Rue Joliot Curie, 91190 Gif-sur-Yvette, France (L.M., M.V.).
- Department of Urology and Renal Transplantation, Georges Pompidou European Hospital, APHP, 20 Rue Leblanc, 75015 Paris, France (F.P., M.O.T.); UFR Médecine, Paris-Cité University, 15 Rue de l'Ecole de Médecine, 75006 Paris, France (J.M.C., D.A., M.O.T.).
Abstract
End-stage renal disease is characterized by an irreversible decline in kidney function. Despite a risk of chronic dysfunction of the transplanted kidney, renal transplantation is considered the most effective solution among available treatment options. Clinical attributes of graft survival prediction, such as allocation variables or results of pathological examinations, have been widely studied. Nevertheless, medical imaging is clinically used only to assess current transplant status. This study investigated the use of unsupervised deep learning-based algorithms to identify rich radiomic features that may be linked to graft survival from early dynamic contrast-enhanced magnetic resonance imaging data of renal transplants. A retrospective cohort of 108 transplanted patients (mean age 50 +/- 15, 67 men) undergoing systematic magnetic resonance imaging follow-up examinations (2013 to 2015) was used to train deep convolutional neural network models based on an unsupervised contrastive learning approach. 5-year graft survival analysis was performed from the obtained artificial intelligence radiomics features using penalized Cox models and Kaplan-Meier estimates. Using a validation set of 48 patients (mean age 54 +/- 13, 30 men) having 1-month post-transplantation magnetic resonance imaging examinations, the proposed approach demonstrated promising 5-year graft survival capability with a 72.7% concordance index from the artificial intelligence radiomics features. Unsupervised clustering of these radiomics features enabled statistically significant stratification of patients (p=0.029). This proof-of-concept study exposed the promising capability of artificial intelligence algorithms to extract relevant radiomics features that enable renal transplant survival prediction. Further studies are needed to demonstrate the robustness of this technique, and to identify appropriate procedures for integration of such an approach into multimodal and clinical settings.