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Mutaciones conductoras concurrentes inducen distintas morfologías tumorales en imágenes radiológicas

Diana Ivonne Rodríguez Sánchez1, Thera Vanneste2, Julian Middelkoop2

  • 1GROW Research Institute for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands; Department of Radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.

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Resumen

Las comutaciones del cáncer crean fenotipos de imagen únicos distintos de las mutaciones únicas, revelando una biología tumoral compleja. La radiogenómica debe modelar explícitamente estos contextos de comutación para una estratificación precisa del cáncer no invasiva.

Palabras clave:
Inteligencia ArtificialComutacionesTomografía ComputarizadaEGFRKRASOncología de PrecisiónRadiogenómicaRadiómicaTP53Morfología Tumoral

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Área de la Ciencia:

  • Radiogenómica
  • Genómica del Cáncer
  • Imagen Médica

Sus antecedentes:

  • La mayoría de los estudios de radiogenómica analizan mutaciones conductoras únicas de forma aislada.
  • Las alteraciones conductoras concurrentes son comunes en el cáncer y pueden interactuar funcionalmente.
  • Sigue sin saberse si las mutaciones concurrentes crean fenotipos de imagen distintos o simplemente promedian los efectos de mutaciones únicas.

Objetivo del estudio:

  • Investigar si las mutaciones conductoras concurrentes en pacientes con cáncer resultan en fenotipos de imagen distintos en comparación con mutaciones únicas.
  • Determinar si las mutaciones concurrentes producen efectos aditivos o emergentes en las características de imagen.
  • Explorar la utilidad de la radiómica para identificar fenotipos específicos del genotipo en una cohorte multicanal.

Principales métodos:

  • Análisis retrospectivo de 1235 pacientes con 8633 lesiones segmentadas de exploraciones de TC con contraste y perfilado genómico emparejado.
  • Comparación de fenotipos de imagen en grupos de pacientes: sin mutaciones conductoras, TP53 + otras, solo TP53, solo EGFR, solo KRAS y comutaciones específicas (TP53 + EGFR, TP53 + KRAS).
  • Cuantificación de la separación fenotípica utilizando la distancia del centroide y la distancia interpaciente entre grupos, con reducción de dimensionalidad a nivel de lesión y análisis de geometría de ejes parentales para probar la emergencia más allá de la aditividad.

Principales resultados:

  • Las cohortes de mutantes únicas (solo EGFR vs. solo KRAS, solo TP53 vs. solo EGFR) exhibieron fenotipos distintos.
  • Los tumores comutados demostraron una separación de los grupos parentales de mutantes únicas en análisis a nivel de paciente y a nivel de lesión.
  • Las lesiones comutadas fueron morfológicamente más cercanas a las cohortes de solo TP53 que a las cohortes de solo EGFR o solo KRAS.
  • La emergencia más allá de la aditividad fue respaldada estadísticamente para las comutaciones TP53 + EGFR y tendió para TP53 + KRAS.

Conclusiones:

  • La radiómica de TC puede identificar fenotipos específicos del genotipo en varios cánceres.
  • Las comutaciones generan características morfológicas distintas detectables a través de imágenes.
  • El modelado explícito del contexto de comutación es crucial para avanzar en la radiogenómica y permitir la estratificación molecular no invasiva del cáncer.