Ying Liu1, Jongphil Kim2, Yoganand Balagurunathan3, Qian Li1, Alberto L Garcia3, Olya Stringfield3, Zhaoxiang Ye4, Robert J Gillies5. 1. Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, PR China; Department of Cancer Imaging and Metabolism, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL. 2. Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL. 3. Department of Cancer Imaging and Metabolism, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL. 4. Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, PR China. Electronic address: yezhaoxiang@163.com. 5. Department of Cancer Imaging and Metabolism, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Department of Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL. Electronic address: Robert.Gillies@moffitt.org.
Abstract
BACKGROUND: In this study we retrospectively evaluated the capability of computed tomography (CT)-based radiomic features to predict epidermal growth factor receptor (EGFR) mutation status in surgically-resected peripheral lung adenocarcinomas in an Asian cohort of patients. PATIENTS AND METHODS: Two hundred ninety-eight patients with surgically resected peripheral lung adenocarcinomas were investigated in this institutional review board-approved retrospective study with requirement waived to obtain informed consent. Two hundred nineteen quantitative 3-D features were extracted from segmented volumes of each tumor, and 59 of these, which were considered independent features, were included in the analysis. Clinical and pathological information was obtained from the institutional database. RESULTS: Mutant EGFR was significantly associated with female sex (P = .0005); never smoker status (P < .0001), lepidic predominant adenocarcinomas (P = .017), and low or intermediate pathologic grade (P = .0002). Statistically significant differences were found in 11 radiomic features between EGFR mutant and wild type groups in univariate analysis. Mutant EGFR status could be predicted by a set of 5 radiomic features that fell into 3 broad groups: CT attenuation energy, tumor main direction, and texture defined according to wavelets and Laws (area under the curve [AUC], 0.647). A multiple logistic regression model showed that adding radiomic features to a clinical model resulted in a significant improvement of predicting power, because the AUC increased from 0.667 to 0.709 (P < .0001). CONCLUSION: Computed tomography-based radiomic features of peripheral lung adenocarcinomas can capture useful information regarding tumor phenotype, and the model we built can be useful to predict the presence of EGFR mutations in peripheral lung adenocarcinoma in Asian patients when mutational profiling is not available or possible.
BACKGROUND: In this study we retrospectively evaluated the capability of computed tomography (CT)-based radiomic features to predict epidermal growth factor receptor (EGFR) mutation status in surgically-resected peripheral lung adenocarcinomas in an Asian cohort of patients. PATIENTS AND METHODS: Two hundred ninety-eight patients with surgically resected peripheral lung adenocarcinomas were investigated in this institutional review board-approved retrospective study with requirement waived to obtain informed consent. Two hundred nineteen quantitative 3-D features were extracted from segmented volumes of each tumor, and 59 of these, which were considered independent features, were included in the analysis. Clinical and pathological information was obtained from the institutional database. RESULTS: Mutant EGFR was significantly associated with female sex (P = .0005); never smoker status (P < .0001), lepidic predominant adenocarcinomas (P = .017), and low or intermediate pathologic grade (P = .0002). Statistically significant differences were found in 11 radiomic features between EGFR mutant and wild type groups in univariate analysis. Mutant EGFR status could be predicted by a set of 5 radiomic features that fell into 3 broad groups: CT attenuation energy, tumor main direction, and texture defined according to wavelets and Laws (area under the curve [AUC], 0.647). A multiple logistic regression model showed that adding radiomic features to a clinical model resulted in a significant improvement of predicting power, because the AUC increased from 0.667 to 0.709 (P < .0001). CONCLUSION: Computed tomography-based radiomic features of peripheral lung adenocarcinomas can capture useful information regarding tumor phenotype, and the model we built can be useful to predict the presence of EGFR mutations in peripheral lung adenocarcinoma in Asian patients when mutational profiling is not available or possible.
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