1
|
Huang Z, Tu X, Yu T, Zhan Z, Lin Q, Huang X. Peritumoural MRI radiomics signature of brain metastases can predict epidermal growth factor receptor mutation status in lung adenocarcinoma. Clin Radiol 2024; 79:e305-e316. [PMID: 38000953 DOI: 10.1016/j.crad.2023.10.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 10/05/2023] [Accepted: 10/18/2023] [Indexed: 11/26/2023]
Abstract
AIM To investigate whether magnetic resonance imaging (MRI) radiomics features of brain metastases (BMs) can predict epidermal growth factor receptor (EGFR) mutation status in lung adenocarcinoma. MATERIALS AND METHODS Between June 2014 and December 2022, 58 histopathologically confirmed lung adenocarcinoma patients (27 with EGFR wild-type, 31 with EGFR mutation) who underwent gadobenate dimeglumine-enhanced brain MRI were recruited retrospectively. A total of 123 metastatic brain lesions were allocated randomly into the training cohort (n=86) and test cohort (n=37) at a ratio of 7:3. Radiomics models based on multi-sequence MRI images in different regions such as volume of interest (VOI)enhancing tumour, VOIwholetumour, VOIperitumour 1mm, VOIperitumour 3mm, and VOIperitumour 5mm were built. The optimal radiomics model was integrated into the clinical or radiological indicators to construct a fusion model through multivariable logistic regression analysis. RESULTS The optimal radiomics model based on the VOIperitumour 1mm, a combination of nine features selected from the fluid-attenuated inversion recovery (FLAIR) sequence, yielded areas under the curves (AUCs) of >0.75 in the training and test cohorts. The prediction of the fusion model with integration of clinical factors (age) and radiomics score (the optimal radiomics model) was not better than that of the optimal radiomics model alone in the test cohort (AUC: 0.808 and 0.785, respectively, p=0.525). CONCLUSION The FLAIR radiomics model based on VOIperitumour 1mm as an effective biomarker helps predict EGFR mutation status in lung adenocarcinoma patients with BMs and then assists clinicians in selecting optimal treatment strategies.
Collapse
Affiliation(s)
- Z Huang
- Department of Radiology, Longyan First Affiliated Hospital of Fujian Medical University, No. 105 North 91 Road, Xinluo District, Fujian, 364000, China.
| | - X Tu
- Department of Orthopedics, Longyan First Affiliated Hospital of Fujian Medical University, No. 105 North 91 Road, Xinluo District, Fujian, 364000, China
| | - T Yu
- Department of Radiology, Longyan First Affiliated Hospital of Fujian Medical University, No. 105 North 91 Road, Xinluo District, Fujian, 364000, China
| | - Z Zhan
- Department of Radiology, Longyan First Affiliated Hospital of Fujian Medical University, No. 105 North 91 Road, Xinluo District, Fujian, 364000, China
| | - Q Lin
- Department of Radiology, Longyan First Affiliated Hospital of Fujian Medical University, No. 105 North 91 Road, Xinluo District, Fujian, 364000, China
| | - X Huang
- Department of Radiology, Longyan First Affiliated Hospital of Fujian Medical University, No. 105 North 91 Road, Xinluo District, Fujian, 364000, China
| |
Collapse
|
2
|
Park YW, An C, Lee J, Han K, Choi D, Ahn SS, Kim H, Ahn SJ, Chang JH, Kim SH, Lee SK. Diffusion tensor and postcontrast T1-weighted imaging radiomics to differentiate the epidermal growth factor receptor mutation status of brain metastases from non-small cell lung cancer. Neuroradiology 2020; 63:343-352. [PMID: 32827069 DOI: 10.1007/s00234-020-02529-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Accepted: 08/16/2020] [Indexed: 12/17/2022]
Abstract
PURPOSE To assess whether the radiomic features of diffusion tensor imaging (DTI) and conventional postcontrast T1-weighted (T1C) images can differentiate the epidermal growth factor receptor (EGFR) mutation status in brain metastases from non-small cell lung cancer (NSCLC). METHODS A total of 99 brain metastases in 51 patients who underwent surgery or biopsy with underlying NSCLC and known EGFR mutation statuses (57 from EGFR wild type, 42 from EGFR mutant) were allocated to the training (57 lesions in 31 patients) and test (42 lesions in 20 patients) sets. Radiomic features (n = 526) were extracted from preoperative MR images including T1C and DTI. Radiomics classifiers were constructed by combinations of five feature selectors and four machine learning algorithms. The trained classifiers were validated on the test set, and the classifier performance was assessed by determining the area under the curve (AUC). RESULTS EGFR mutation status showed an overall discordance rate of 12% between the primary tumors and corresponding brain metastases. The best performing classifier was a combination of the tree-based feature selection and linear discriminant algorithm and 5 features were selected (1 from ADC, 2 from fractional anisotropy, and 2 from T1C images), resulting in an AUC, accuracy, sensitivity, and specificity of 0.73, 78.6%, 81.3%, and 76.9% in the test set, respectively. CONCLUSIONS Radiomics classifiers integrating multiparametric MRI parameters may have potential in differentiating the EGFR mutation status in brain metastases from NSCLC.
Collapse
Affiliation(s)
- Yae Won Park
- Department of Radiology and Research Institute of Radiological Science and Center for Clinical Imaging Data Science, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea
| | - Chansik An
- Research and Analysis Team, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - JaeSeong Lee
- Department of Mechanical Engineering, Yonsei University, Seoul, Korea
| | - Kyunghwa Han
- Department of Radiology and Research Institute of Radiological Science and Center for Clinical Imaging Data Science, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea
| | - Dongmin Choi
- Department of Computer Science, Yonsei University, Seoul, Korea
| | - Sung Soo Ahn
- Department of Radiology and Research Institute of Radiological Science and Center for Clinical Imaging Data Science, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea.
| | - Hwiyoung Kim
- Department of Radiology and Research Institute of Radiological Science and Center for Clinical Imaging Data Science, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea
| | - Sung Jun Ahn
- Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jong Hee Chang
- Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea
| | - Se Hoon Kim
- Department of Pathology, Yonsei University College of Medicine, Seoul, Korea
| | - Seung-Koo Lee
- Department of Radiology and Research Institute of Radiological Science and Center for Clinical Imaging Data Science, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea
| |
Collapse
|
3
|
Lee CC, Soon YY, Tan CL, Koh WY, Leong CN, Tey JCS, Tham IWK. Discordance of epidermal growth factor receptor mutation between primary lung tumor and paired distant metastases in non-small cell lung cancer: A systematic review and meta-analysis. PLoS One 2019; 14:e0218414. [PMID: 31216329 PMCID: PMC6583965 DOI: 10.1371/journal.pone.0218414] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 05/31/2019] [Indexed: 12/19/2022] Open
Abstract
Purpose To evaluate the rate of discordance of epidermal growth factor receptor (EGFR) mutation between primary lung tumor and paired distant metastases in non-small-cell lung cancer (NSCLC). Methods We performed a meta-analysis of 17 studies (518 cases) assessing discordance rates of EGFR mutation in primary tumors and paired distant metastases. We performed subgroup analyses based on EGFR mutation status in primary tumor (mutant or wildtype), site of distant metastasis (bone, central nervous system (CNS) or lung/ pleural), methods of testing (direct sequencing or allele-specific testing) and timing of metastasis (synchronous or metachronous). Results The overall discordance rate in EGFR mutation was low at 10.36% (95% CI = 4.23% to 18.79%) and varied widely between studies (I2 = 83.18%). The EGFR discordance rate was statistically significantly higher in bone metastases (45.49%, 95% CI = 14.13 to 79.02) than CNS (17.26%, 95% CI = 7.64 to 29.74; P = 0.002) and lung/ pleural metastases (8.17%, 95% CI = 3.35 to 14.85; P < 0.001). Subgroup analyses did not demonstrate any significant effect modification on the discordance rates by the EGFR mutation status in primary lung tumor, methods of testing and timing of metastasis. Conclusion The overall discordance rate in EGFR mutation between primary lung tumor and paired distant metastases in NSCLC is low, although higher discordance rates were observed in bone metastases compared with CNS and lung/pleural metastases. Future studies assessing the impact of EGFR mutation discordance on treatment outcomes are required.
Collapse
Affiliation(s)
- Chia Ching Lee
- Department of Radiation Oncology, National University Cancer Institute Singapore, National University Hospital Singapore, Singapore, Singapore
| | - Yu Yang Soon
- Department of Radiation Oncology, National University Cancer Institute Singapore, National University Hospital Singapore, Singapore, Singapore
- * E-mail:
| | - Char Loo Tan
- Department of Pathology, National University Hospital Singapore, Singapore, Singapore
| | - Wee Yao Koh
- Department of Radiation Oncology, National University Cancer Institute Singapore, National University Hospital Singapore, Singapore, Singapore
| | - Cheng Nang Leong
- Department of Radiation Oncology, National University Cancer Institute Singapore, National University Hospital Singapore, Singapore, Singapore
| | - Jeremy Chee Seong Tey
- Department of Radiation Oncology, National University Cancer Institute Singapore, National University Hospital Singapore, Singapore, Singapore
| | - Ivan Weng Keong Tham
- Department of Radiation Oncology, National University Cancer Institute Singapore, National University Hospital Singapore, Singapore, Singapore
| |
Collapse
|
4
|
Liang C, Wu Z, Gan X, Liu Y, You Y, Liu C, Zhou C, Liang Y, Mo H, Chen AM, Zhang J. Detection of Rare Mutations in EGFR-ARMS-PCR-Negative Lung Adenocarcinoma by Sanger Sequencing. Yonsei Med J 2018; 59:13-19. [PMID: 29214771 PMCID: PMC5725350 DOI: 10.3349/ymj.2018.59.1.13] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 09/02/2017] [Accepted: 09/07/2017] [Indexed: 11/27/2022] Open
Abstract
PURPOSE This study aimed to identify potential epidermal growth factor receptor (EGFR) gene mutations in non-small cell lung cancer that went undetected by amplification refractory mutation system-Scorpion real-time PCR (ARMS-PCR). MATERIALS AND METHODS A total of 200 specimens were obtained from the First Affiliated Hospital of Guangzhou Medical University from August 2014 to August 2015. In total, 100 ARMS-negative and 100 ARMS-positive specimens were evaluated for EGFR gene mutations by Sanger sequencing. The methodology and sensitivity of each method and the outcomes of EGFR-tyrosine kinase inhibitor (TKI) therapy were analyzed. RESULTS Among the 100 ARMS-PCR-positive samples, 90 were positive by Sanger sequencing, while 10 cases were considered negative, because the mutation abundance was less than 10%. Among the 100 negative cases, three were positive for a rare EGFR mutation by Sanger sequencing. In the curative effect analysis of EGFR-TKIs, the progression-free survival (PFS) analysis based on ARMS and Sanger sequencing results showed no difference. However, the PFS of patients with a high abundance of EGFR mutation was 12.4 months [95% confidence interval (CI), 11.6-12.4 months], which was significantly higher than that of patients with a low abundance of mutations detected by Sanger sequencing (95% CI, 10.7-11.3 months) (p<0.001). CONCLUSION The ARMS method demonstrated higher sensitivity than Sanger sequencing, but was prone to missing mutations due to primer design. Sanger sequencing was able to detect rare EGFR mutations and deemed applicable for confirming EGFR status. A clinical trial evaluating the efficacy of EGFR-TKIs in patients with rare EGFR mutations is needed.
Collapse
Affiliation(s)
- Chaoyue Liang
- Department of Pulmonary Medicine, The Brain Hospital of Guangxi Zhuang Autonomous Region, Liuzhou, China
| | - Zhuolin Wu
- Department of Biomedical Engineering, University of Minnesota, Twin Cities, Minneapolis, USA
| | - Xiaohong Gan
- Guangzhou Life Technologies Daan Diagnostics Co., Ltd., Guangzhou, China
| | - Yuanbin Liu
- Guangzhou Institute of Respiratory Disease, Guangzhou, China
- Department of Internal Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - You You
- Guangzhou Institute of Respiratory Disease, Guangzhou, China
- Department of Internal Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Chenxian Liu
- Department of Pulmonary Medicine, The Brain Hospital of Guangxi Zhuang Autonomous Region, Liuzhou, China
| | - Chengzhi Zhou
- Guangzhou Institute of Respiratory Disease, Guangzhou, China
- Department of Internal Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Ying Liang
- Guangzhou Institute of Respiratory Disease, Guangzhou, China
| | - Haiyun Mo
- Department of Health Care, Maternal and Child Health Hospital of Haizhu District, Guangzhou, China
| | - Allen M Chen
- Guangzhou Life Technologies Daan Diagnostics Co., Ltd., Guangzhou, China
- Mendel Genes, Inc., Manhattan Beach, CA, USA.
| | - Jiexia Zhang
- Guangzhou Institute of Respiratory Disease, Guangzhou, China
- Department of Internal Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
| |
Collapse
|