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. 2021 Jul 9;11:14251. doi: 10.1038/s41598-021-93414-2

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© The Author(s) 2021

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

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Illustration of ROIs and corresponding histological findings in representative cases of non-muscle invasive UTUC and muscle invasive UTUC. (A–C) In non-muscle invasive UTUC, unenhanced (A), nephrogenic (B) and excretory (C) images are shown synchronically to detect tumor in the renal pelvis, and the ROI (red oval) was determined. (D) The histogram of CT value in HU in the tumor revealed a shape with almost a single peak. (E) Hematoxylin and eosin staining showed typical non-invasive papillary urothelial carcinoma. (F) Image analysis to estimate the amount of stromal components in tumor tissue using Image J software. An appropriate threshold was drawn to distinguish tumor cells and stromal components. (G–I) In muscle invasive UTUC, the ROI was determined with unenhanced (G), nephrogenic (H) and excretory (I) images. (J) The histogram revealed a shape with a broad base and multiple peaks. (K) Hematoxylin and eosin staining showed muscle invasive urothelial carcinoma. (L) Image analysis using Image J software. ROI = region of interest, UTUC = upper tract urothelial carcinoma, CT = computed tomography, HU = Hounsfield unit, SD = standard deviation, TA = texture analysis.