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Yanqing Ma,1 Xiren Xu,1 Peipei Pang,2 Yang Wen1 1Department of Radiology, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou, 310000, People’s Republic of China; 2Department of Pharmaceuticals Diagnosis, GE Healthcare, Hangzhou, 310000, People’s Republic of ChinaCorrespondence: Yanqing MaDepartment of Radiology, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou, 310000, People’s Republic of ChinaEmail 704180026@qq.comObjective: This study aimed to evaluate the role of tumor and mini-peritumor in the context of CT-based radiomics analysis to differentiate fat-poor angiomyolipoma (fp-AML) from clear cell renal cell carcinoma (ccRCC).Methods: A total of 58 fp-AMLs and 172 ccRCCs were enrolled. The volume of interest (VOI) was manually delineated in the standardized CT images and radiomics features were automatically calculated with software. After methods of feature selection, the CT-based logistic models including tumoral model (Ra-tumor), mini-peritumoral model (Ra-peritumor), perirenal model (Ra-Pr), perifat model (Ra-Pf), and tumoral+perirenal model (Ra-tumor+Pr) were constructed. The area under curves (AUCs) were calculated by DeLong test to evaluate the efficiency of logistic models.Results: The AUCs of Ra-peritumor of nephrographic phase (NP) were slightly higher than those of corticomedullary phase (CMP). Furthermore, the Ra-Pr showed significant higher efficiency than the Ra-Pf, and relative more optimal radiomics features were selected in the Ra-Pr than Ra-Pf. The Ra-tumor+Pr combined tumoral and perirenal radiomics analysis was of most significant in distinction compared with Ra-tumor and Ra-peritumor.Conclusion: The validity of NP to differentiate fp-AML from ccRCC was slightly higher than that of CMP. To the NP analysis, the Ra-Pr was superior to the Ra-Pf in distinction, and the lesions invaded to the perirenal tissue more severely than to the perifat tissue. It is important to the individual therapeutic surgeries according to the different lesion location. The pooled tumoral and perirenal radiomics analysis was the most promising approach in distinguishing fp-AML and ccRCC.Keywords: computed tomography, angiomyolipoma, clear cell renal cell carcinoma, peritumor, radiomics