Computed Tomography Imaging Characteristics: Potential Indicators of Epidermal Growth Factor Receptor Mutation in Lung Adenocarcinoma.

Abstract

PURPOSE:

The purpose of this study was to investigate the correlation between computed tomography imaging characteristics in lung adenocarcinoma and epidermal growth factor receptor (EGFR) mutations.

METHODS:

A total of 124 patients with lung adenocarcinoma and known EGFR mutation status were collected in this retrospective study. Computed tomography quantitative parameters of each tumor, including total volume, total surface, surface-to-volume ratio (SVR), average diameter, maximum diameter, and average density, were determined using computer-aided detection software. The correlation between the EGFR mutation status and imaging characteristics was assessed. The predictive value of these imaging characteristics for EGFR mutation was calculated using the area under the receiver operating characteristic curve.

RESULT:

Fifty-eight of 124 patients showed EGFR mutations. Patients who are female (P < 0.001) and nonsmokers (P < 0.001) and those with serum carcinoembryonic antigen (CEA) level of ≥5 (P = 0.035) were likely to have EGFR mutation. Computed tomography features including air bronchogram (P = 0.035), absence of cavitation (P = 0.010), and absence of pulmonary emphysema (P = 0.002) and quantitative parameters, such as smaller total surface (P = 0.002), smaller total volume (P = 0.001), higher SVR (P = 0.003), and smaller average diameter (P = 0.001), were associated with EGFR mutation. Logistic regression analysis revealed that the most significant independent prognostic factors of EGFR mutation for the model were nonsmoking (P = 0.035), CEA level of ≥5 (P = 0.004), presence of air bronchogram (P = 0.040), absence of cavitation (P = 0.021), and high SVR (P = 0.014). The area under the receiver operating characteristic curve, sensitivity, and specificity of the model for predicting EGFR mutation were 0.827, 75.8%, and 82.8%, respectively.

CONCLUSIONS:

EGFR-mutated adenocarcinoma showed significantly increased CEA level, presence of air bronchogram, absence of cavitation, and higher quantitative parameter SVR than those with wild-type EGFR.

• Authors: Bin Wang, Nan Yu, Dong Han, Zhanli Ren, Yongjun Jia, Xirong Zhang, Taiping He
• Journal: Journal of computer assisted tomography (J Comput Assist Tomogr) 2021 Nov-Dec 01 Vol. 45 Issue 6 Pg. 964-969 ISSN: 1532-3145 [Electronic] United States
• PMID: 34581708 (Publication Type: Journal Article)
• Copyright: Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

Chemical References

• EGFR protein, human
• ErbB Receptors

Topics

• Adenocarcinoma of Lung (diagnostic imaging, genetics)
• ErbB Receptors (genetics)
• Female
• Humans
• Lung (diagnostic imaging)
• Lung Neoplasms (diagnostic imaging, genetics)
• Male
• Middle Aged
• Mutation (genetics)
• Retrospective Studies
• Sensitivity and Specificity
• Tomography, X-Ray Computed (methods)