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High-resolution computed tomography findings independently predict epidermal growth factor receptor mutation status
Ping Zhu1, Xiao-Jun Xu1, Min-Ming Zhang1
1Department of Radiology, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310005, Zhejiang Province, China.
Background:
For lung adenocarcinoma with epidermal growth factor receptor (EGFR) gene mutation, small molecule tyrosine kinase inhibitors are more effective. Some patients could not obtain enough histological specimens for EGFR gene mutation detection. Specific imaging features can predict EGFR mutation status to a certain extent.
Aim:
To assess the associations of EGFR mutations with high-resolution computerized tomography (HRCT) features in ground-glass nodular lung adenocarcinoma.
Methods:
This study retrospectively assessed patients with ground-glass nodular lung adenocarcinoma diagnosed between January 2011 and March 2017. EGFR gene mutations in exons 18-21 were detected. The patients were classified into mutant EGFR and wild-type groups, and general data and HRCT image characteristics were assessed.
Results:
Among 98 patients, 31 (31.6%) and 67 (68.4%) had mutated and wild-type EGFR in exons 18-21, respectively. Gender, age, smoking history, location of lesions, morphology, edges, borders, pleural indentations, and associations of nodules with bronchus and blood vessels were comparable in both groups (all P > 0.05). Patients with mutant EGFR had larger nodules than those with the wild-type (17.19 ± 6.79 and 14.37 ± 6.30 mm, respectively; P = 0.047). Meanwhile, the vacuole/honeycomb sign was more frequent in the mutant EGFR group (P = 0.011). The logistic regression prediction model included the combination of nodule size and vacuole/honeycomb sign (OR = 1.120, 95%CI: 1.023-1.227, P = 0.014) revealed a sensitivity of 83.9%, a specificity of 52.2% and an AUC of 0.698 (95%CI: 0.589-0.806; P = 0.002).
Conclusion:
Nodule size and vacuole/honeycomb features could independently predict EGFR mutation status in ground-glass nodular lung adenocarcinoma.
Insights
Lung adenocarcinoma with epidermal growth factor receptor (EGFR) mutations can be predicted by imaging. Nodule size and vacuole/honeycomb signs on CT scans may indicate EGFR mutation status.
Area of Science:
- Pulmonary Medicine
- Oncology
- Radiology
Background:
- Epidermal growth factor receptor (EGFR) mutations are crucial in lung adenocarcinoma treatment.
- Small molecule tyrosine kinase inhibitors are effective for EGFR-mutated lung cancer.
- Histological specimen limitations necessitate alternative methods for EGFR mutation detection.
Purpose of the Study:
- To investigate the association between high-resolution computerized tomography (HRCT) features and EGFR mutations in ground-glass nodular lung adenocarcinoma.
- To identify specific imaging characteristics that may predict EGFR mutation status.
Main Methods:
- Retrospective analysis of 98 patients with ground-glass nodular lung adenocarcinoma.
- Detection of EGFR gene mutations in exons 18-21.
- Assessment of HRCT image characteristics and correlation with mutation status.
Main Results:
- No significant differences in general data or most HRCT features between mutant and wild-type EGFR groups.
- Mutant EGFR group showed significantly larger nodules (17.19 ± 6.79 mm) compared to wild-type (14.37 ± 6.30 mm).
- The vacuole/honeycomb sign was more frequent in the mutant EGFR group, with a combined prediction model (nodule size and vacuole/honeycomb sign) showing 83.9% sensitivity and 52.2% specificity.
Conclusions:
- Nodule size and the vacuole/honeycomb sign are independent predictors of EGFR mutation status in ground-glass nodular lung adenocarcinoma.
- HRCT features can aid in predicting EGFR mutation status when tissue biopsy is insufficient.
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