Stefania Rizzo1, Francesco Petrella2, Valentina Buscarino3, Federica De Maria3, Sara Raimondi4, Massimo Barberis5, Caterina Fumagalli5, Gianluca Spitaleri6, Cristiano Rampinelli7, Filippo De Marinis6, Lorenzo Spaggiari2, Massimo Bellomi7,3. 1. Department of Radiology, European Institute of Oncology, via Ripamonti 435, 20141, Milan, Italy. stefania.rizzo@ieo.it. 2. Department of Thoracic Surgery, European Institute of Oncology, via Ripamonti 435, 20141, Milan, Italy. 3. Department of Health Sciences, University of Milan, via A. di Rudinì 8, 20142, Milan, Italy. 4. Department of Epidemiology and Biostatistics, European Institute of Oncology, via Ramusio, 1, 20141, Milan, Italy. 5. Department of Pathology, European Institute of Oncology, via Ripamonti 435, 20141, Milan, Italy. 6. Department of Thoracic Oncology, European Institute of Oncology, via Ripamonti 435, 20141, Milan, Italy. 7. Department of Radiology, European Institute of Oncology, via Ripamonti 435, 20141, Milan, Italy.
Abstract
OBJECTIVES: To assess the association between CT features and EGFR, ALK, KRAS mutations in non-small cell lung cancer. METHODS: Patients undergoing chest CT and testing for the above gene mutations were included. Qualitative evaluation of CTs included: lobe; lesion diameter; shape; margins; ground-glass opacity; density; cavitation; air bronchogram; pleural thickening; intratumoral necrosis; nodules in tumour lobe; nodules in non-tumour lobes; pleural retraction; location; calcifications; emphysema; fibrosis; pleural contact; pleural effusion. Statistical analysis was performed to assess association of features with each gene mutation. ROC curves for gene mutations were drawn; the corresponding area under the curve was calculated. P-values <0.05 were considered significant. RESULTS: Of 285 patients, 60/280 (21.43 %) were positive for EGFR mutation; 31/270 (11.48 %) for ALK rearrangement; 64/240 (26.67 %) for KRAS mutation. EGFR mutation was associated with air bronchogram, pleural retraction, females, non-smokers, small lesion size, and absence of fibrosis. ALK rearrangements were associated with age and pleural effusion. KRAS mutation was associated with round shape, nodules in non-tumour lobes, and smoking. CONCLUSIONS: This study disclosed associations between CT features and alterations of EGFR (air bronchogram, pleural retraction, small lesion size, absence of fibrosis), ALK (pleural effusion) and KRAS (round lesion shape, nodules in non-tumour lobes). KEY POINTS: 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.
OBJECTIVES: To assess the association between CT features and EGFR, ALK, KRAS mutations in non-small cell lung cancer. METHODS:Patients undergoing chest CT and testing for the above gene mutations were included. Qualitative evaluation of CTs included: lobe; lesion diameter; shape; margins; ground-glass opacity; density; cavitation; air bronchogram; pleural thickening; intratumoral necrosis; nodules in tumour lobe; nodules in non-tumour lobes; pleural retraction; location; calcifications; emphysema; fibrosis; pleural contact; pleural effusion. Statistical analysis was performed to assess association of features with each gene mutation. ROC curves for gene mutations were drawn; the corresponding area under the curve was calculated. P-values <0.05 were considered significant. RESULTS: Of 285 patients, 60/280 (21.43 %) were positive for EGFR mutation; 31/270 (11.48 %) for ALK rearrangement; 64/240 (26.67 %) for KRAS mutation. EGFR mutation was associated with air bronchogram, pleural retraction, females, non-smokers, small lesion size, and absence of fibrosis. ALK rearrangements were associated with age and pleural effusion. KRAS mutation was associated with round shape, nodules in non-tumour lobes, and smoking. CONCLUSIONS: This study disclosed associations between CT features and alterations of EGFR (air bronchogram, pleural retraction, small lesion size, absence of fibrosis), ALK (pleural effusion) and KRAS (round lesion shape, nodules in non-tumour lobes). KEY POINTS: 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.
Authors: I Yoshino; R Nakanishi; M Kodate; T Osaki; T Hanagiri; M Takenoyama; T Yamashita; H Imoto; S Taga; K Yasumoto Journal: Int Surg Date: 2000 Apr-Jun
Authors: Gregory J Riely; Mark G Kris; Daniel Rosenbaum; Jenifer Marks; Allan Li; Dhananjay A Chitale; Khedoudja Nafa; Elyn R Riedel; Meier Hsu; William Pao; Vincent A Miller; Marc Ladanyi Journal: Clin Cancer Res Date: 2008-09-15 Impact factor: 12.531
Authors: Bruno Hochhegger; Matheus Zanon; Stephan Altmayer; Gabriel S Pacini; Fernanda Balbinot; Martina Z Francisco; Ruhana Dalla Costa; Guilherme Watte; Marcel Koenigkam Santos; Marcelo C Barros; Diana Penha; Klaus Irion; Edson Marchiori Journal: Lung Date: 2018-10-09 Impact factor: 2.584
Authors: Philippe Lambin; Ralph T H Leijenaar; Timo M Deist; Jurgen Peerlings; Evelyn E C de Jong; Janita van Timmeren; Sebastian Sanduleanu; Ruben T H M Larue; Aniek J G Even; Arthur Jochems; Yvonka van Wijk; Henry Woodruff; Johan van Soest; Tim Lustberg; Erik Roelofs; Wouter van Elmpt; Andre Dekker; Felix M Mottaghy; Joachim E Wildberger; Sean Walsh Journal: Nat Rev Clin Oncol Date: 2017-10-04 Impact factor: 66.675
Authors: Juheon Lee; Yi Cui; Xiaoli Sun; Bailiang Li; Jia Wu; Dengwang Li; Michael F Gensheimer; Billy W Loo; Maximilian Diehn; Ruijiang Li Journal: Eur Radiol Date: 2017-08-07 Impact factor: 5.315
Authors: Emmanuel Rios Velazquez; Chintan Parmar; Ying Liu; Thibaud P Coroller; Gisele Cruz; Olya Stringfield; Zhaoxiang Ye; Mike Makrigiorgos; Fiona Fennessy; Raymond H Mak; Robert Gillies; John Quackenbush; Hugo J W L Aerts Journal: Cancer Res Date: 2017-05-31 Impact factor: 12.701