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区分EGFR突变分子亚型基于MRI放射学特征的肺腺癌脑转移的肺腺癌

Jiali Xu¹, Yuqiong Yang², Zhizhen Gao³

¹Department of Radiology, The First Affiliated Hospital of Bengbu Medical University, Bengbu, Anhui 233004, China; Department of Medical Imaging Diagnosis, School of Medical Imaging, Bengbu Medical University, Bengbu, Anhui, China.

Clinical neurology and neurosurgery

|March 29, 2024

概括

这项研究表明,肺腺癌脑转移MRI的放射特征可以识别表皮生长因子受体 (EGFR) 突变亚型. 这种非侵入性方法有助于预测原发性瘤中的EGFR 19Del和21L858R突变.

科学领域:

放射学和成像学放射学和成像学
在瘤学瘤学.
分子诊断学分子诊断学

背景情况:

肺腺癌 (LUAD) 是癌症相关死亡的主要原因.
表皮生长因子受体 (EGFR) 突变是LUAD的关键驱动因素,影响治疗决策.
区分常见的EGFR突变 (19Del和21L858R) 对于向治疗的选择至关重要.

研究的目的:

评估使用脑转移MRI的放射学来预测初级LUAD病变中的EGFR突变亚型的可行性.
开发和验证一个基于放射学模型,以区分EGFR第19个外因子删除 (19Del) 和第21个外因子L858R点突变 (21L858R).

主要方法:

追溯分析86名LUAD患者的大脑转移和已知的EGFR突变状态.
从对比度增强的T1加权MRI扫描脑转移的3D放射特征的提取.
使用主要组件分析,浮纹特征选择和自适应增强分类开发放射学模型,经过交叉验证和独立测试集验证.

主要成果:

放射学模型在训练组中达到0.895的曲线下面面积 (AUC),在测试组中达到0.759,用于区分19Del和21L858R突变.
患者年龄被确定为一个独立的预测因素.
结合年龄和放射学模型的AUC略高 (0.888) 比仅仅放射学 (0.866),两种模型都显示出临床效用.

结论:

在MRI上对肺腺癌脑转移的放射性分析可以成功预测原发性瘤中的EGFR 19Del和21L858R突变.
这种非侵入性成像方法为分子亚型提供了潜在的方法,有助于为LUAD患者提供个性化治疗策略.

关键词:

大脑转移是大脑的转移.欧洲农业基金会 (EGFR) 是一个.肺部腺癌瘤是肺部腺癌.这就是为什么MRI是MRI.无线电学 (Radiomics) 是一种辐射学.

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