CT Radiogenomic Characterization of EGFR, K-RAS, and ALK Mutations in Non-Small Cell Lung Cancer

Rizzo, Stefania; Petrella, Francesco; Buscarino, Valentina; Maria, Federica De; Raimondi, Sara; Barberis, Massimo; Fumagalli, Caterina; Spitaleri, Gianluca; Rampinelli, Cristiano; Marinis, Filippo de; Spaggiari, Lorenzo; Bellomi, Massimo

doi:10.1007/s00330-015-3814-0

Cited by 218 publications

(190 citation statements)

References 32 publications

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“…They found that spiculated margin, pleural retraction, and air bronchogram were more frequent in the EGFR mutation group than in the wild-type group, but there was no significant difference between convergence, thickened adjacent bronchovascular bundles, or pleural retraction were more likely to be tumors with EGFR mutations, while tumors with pleural attachment, well-defined margins, marked heterogeneous enhancement, severe peripheral emphysema, severe peripheral fibrosis, or lymphadenopathy were more likely to be wild-type tumors. Some of these findings are consistent with findings of previous studies (18,19) but are contrary to the findings of Sugano et al (16). These conflicting results among studies may be due to differences in study design and grouping method.…”

Section: Thoracic Imaging: Epidermal Growth Factor Receptor Mutation supporting

confidence: 73%

“…In the current study, we quantified 30 detailed CT features and found that tumors of smaller size, as well as those with spiculation, a GGO component, air bronchogram, bubblelike lucency, vascular these groups. In another study (19), there were significantly higher percentages of air bronchogram, pleural retraction, or absence of emphysema among patients with an EGFR mutation. However, CT features related to contrast material enhancement of the Association between CT Features with EGFR Mutation Status may have caused a selection bias.…”

Section: Thoracic Imaging: Epidermal Growth Factor Receptor Mutation mentioning

confidence: 86%

“…To date, relatively few studies have investigated the relationships between CT imaging features with EGFR mutations (14)(15)(16)(17)(18)(19)(20). Most of these studies have focused on ground-glass opacity (GGO) ratio, and some of the findings are conflicting.…”

Section: Ct Image Interpretationmentioning

confidence: 99%

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CT Features Associated with Epidermal Growth Factor Receptor Mutation Status in Patients with Lung Adenocarcinoma

Liu¹,

Kim²,

Qu³

et al. 2016

Radiology

181

168

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).q RSNA, 2016 Purpose:To retrospectively identify the relationship between epidermal growth factor receptor (EGFR) mutation status, predominant histologic subtype, and computed tomographic (CT) characteristics in surgically resected lung adenocarcinomas in a cohort of Asian patients. materials andMethods:This study was approved by the institutional review board, with waiver of informed consent. Preoperative chest CT findings were retrospectively evaluated in 385 surgically resected lung adenocarcinomas. A total of 30 CT descriptors were assessed. EGFR mutations at exons 18-21 were determined by using the amplification refractory mutation system. Multiple logistic regression analyses were performed to identify independent factors of harboring EGFR mutation status. The final model was selected by using the backward elimination method, and two areas under the receiver operating characteristic curve (ROC) were compared with the nonparametric approach of DeLong, DeLong, and Clarke-Pearson. Results:EGFR mutations were found in 168 (43.6%) of 385 patients. Mutations were found more frequently in (a) female patients (P , .001); (b)those who had never smoked (P , .001); (c)those with lepidic predominant adenocarcinomas (P = .001) or intermediate pathologic grade (P , .001); (e) smaller tumors (P , .001); (f) tumors with spiculation (P = .019), ground-glass opacity (GGO) or mixed GGO (P , .001), air bronchogram (P = .006), bubblelike lucency (P , .001), vascular convergence (P = .024), thickened adjacent bronchovascular bundles (P = .027), or pleural retraction (P , .001); and (g) tumors without pleural attachment (P = .004), a well-defined margin (P = .010), marked heterogeneous enhancement (P = .001), severe peripheral emphysema (P = .002), severe peripheral fibrosis (P = .013), or lymphadenopathy (P = .028). The most important and significantly independent prognostic factors of harboring EGFR-activating mutation for the model with both clinical variables and CT features were those who had never smoked and those with smaller tumors, bubblelike lucency, homogeneous enhancement, or pleural retraction when adjusting for histologic subtype, pathologic grade, or thickened adjacent bronchovascular bundles. ROC curve analysis showed that use of clinical variables combined with CT features (area under the ROC curve = 0.778) was superior to use of clinical variables alone (area under the ROC curve = 0.690). Conclusion:CT imaging features of lung adenocarcinomas in combination with clinical variables can be used to prognosticate EGFR mutation status better than use of clinical variables alone.q RSNA, 2016

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Section: Thoracic Imaging: Epidermal Growth Factor Receptor Mutation supporting

confidence: 73%

Section: Thoracic Imaging: Epidermal Growth Factor Receptor Mutation mentioning

confidence: 86%

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CT Features Associated with Epidermal Growth Factor Receptor Mutation Status in Patients with Lung Adenocarcinoma

Liu¹,

Kim²,

Qu³

et al. 2016

Radiology

181

168

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“…Based on the abovementioned studies, we may assume that the presence of GGO or higher GGO ratio may be associated with higher frequencies of EGFR mutation. However, the association between GGO and EGFR mutation is still debated because of conflicting results of different studies (39,(43)(44)(45). These controversial results may be the result of different ethnicity, grouping methods, measurement of GGO ratio, sample size and inclusion criteria among studies.…”

Section: Molecular Pathology and Ct Featuresmentioning

confidence: 99%

“…Transl Lung Cancer Res 2017;6(1):68-75 tlcr.amegroups.com of any GGO (43,44,48) or GGO ratio (33). One study (45) revealed that KRAS mutations were more common in lesions with a lower GGO proportion.…”

Section: Molecular Pathology and Ct Featuresmentioning

confidence: 99%

Pulmonary ground-glass opacity: computed tomography features, histopathology and molecular pathology

Gao

Rizzo

et al. 2017

Transl. Lung Cancer Res.

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Optimization of a secondary VOI protocol for lung imaging in a clinical CT scanner

Larsen

Gopalakrishnan

Yao

et al. 2018

J Applied Clin Med Phys

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We present a solution to meet an unmet clinical need of an in‐situ “close look” at a pulmonary nodule or at the margins of a pulmonary cyst revealed by a primary (screening) chest CT while the patient is still in the scanner. We first evaluated options available on current whole‐body CT scanners for high resolution screening scans, including ROI reconstruction of the primary scan data and HRCT, but found them to have insufficient SNR in lung tissue or discontinuous slice coverage. Within the capabilities of current clinical CT systems, we opted for the solution of a secondary, volume‐of‐interest (VOI) protocol where the radiation dose is focused into a short‐beam axial scan at the z position of interest, combined with a small‐FOV reconstruction at the xy position of interest. The objective of this work was to design a VOI protocol that is optimized for targeted lung imaging in a clinical whole‐body CT system. Using a chest phantom containing a lung‐mimicking foam insert with a simulated cyst, we identified the appropriate scan mode and optimized both the scan and recon parameters. The VOI protocol yielded 3.2 times the texture amplitude‐to‐noise ratio in the lung‐mimicking foam when compared to the standard chest CT, and 8.4 times the texture difference between the lung mimicking and reference foams. It improved details of the wall of the simulated cyst and better resolution in a line‐pair insert. The Effective Dose of the secondary VOI protocol was 42% on average and up to 100% in the worst‐case scenario of VOI positioning relative to the standard chest CT. The optimized protocol will be used to obtain detailed CT textures of pulmonary lesions, which are biomarkers for the type and stage of lung diseases.

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CT Radiogenomic Characterization of EGFR, K-RAS, and ALK Mutations in Non-Small Cell Lung Cancer

Abstract: Air bronchogram, pleural retraction, small size relate to EGFR mutation in NSCLC. Pleural effusion and younger age relate to ALK mutation. Round lesion shape, nodules in non-tumour lobes relate to KRAS mutation.

Cited by 218 publications

References 32 publications

CT Features Associated with Epidermal Growth Factor Receptor Mutation Status in Patients with Lung Adenocarcinoma

CT Features Associated with Epidermal Growth Factor Receptor Mutation Status in Patients with Lung Adenocarcinoma

Pulmonary ground-glass opacity: computed tomography features, histopathology and molecular pathology

Optimization of a secondary VOI protocol for lung imaging in a clinical CT scanner

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