Artificial Intelligence in Renal Mass Characterization: A Systematic Review of Methodologic Items Related to Modeling, Performance Evaluation, Clinical Utility, and Transparency.

Abstract

<b>OBJECTIVE.</b> The objective of our study was to systematically review the literature about the application of artificial intelligence (AI) to renal mass characterization with a focus on the methodologic quality items. <b>MATERIALS AND METHODS.</b> A systematic literature search was conducted using PubMed to identify original research studies about the application of AI to renal mass characterization. Besides baseline study characteristics, a total of 15 methodologic quality items were extracted and evaluated on the basis of the following four main categories: modeling, performance evaluation, clinical utility, and transparency items. The qualitative synthesis was presented using descriptive statistics with an accompanying narrative. <b>RESULTS.</b> Thirty studies were included in this systematic review. Overall, the methodologic quality items were mostly favorable for modeling (63%) and performance evaluation (63%). Even so, the studies (57%) more frequently constructed their work on nonrobust features. Furthermore, only a few studies (10%) had a generalizability assessment with independent or external validation. The studies were mostly unsuccessful in terms of clinical utility evaluation (89%) and transparency (97%) items. For clinical utility, the interesting findings were lack of comparisons with both radiologists' evaluation (87%) and traditional models (70%) in most of the studies. For transparency, most studies (97%) did not share their data with the public. <b>CONCLUSION.</b> To bring AI-based renal mass characterization from research to practice, future studies need to improve modeling and performance evaluation strategies and pay attention to clinical utility and transparency issues.