Comprehensive analysis of prediction of the EGFR mutation and subtypes based on the spinal metastasis from primary lung adenocarcinoma

Ran Cao; Huanhuan Chen; Huan Wang; Yan Wang; E-Nuo Cui; Wenyan Jiang

doi:10.3389/fonc.2023.1154327

Comprehensive analysis of prediction of the EGFR mutation and subtypes based on the spinal metastasis from primary lung adenocarcinoma

Front Oncol. 2023 Apr 18:13:1154327. doi: 10.3389/fonc.2023.1154327. eCollection 2023.

Authors

Ran Cao¹, Huanhuan Chen², Huan Wang³, Yan Wang¹, E-Nuo Cui⁴, Wenyan Jiang⁵

Affiliations

¹ Department of Biomedical Engineering, School of Intelligent Medicine, China Medical University, Liaoning, Shenyang, China.
² Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, China.
³ Radiation Oncology Department of Thoracic Cancer, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Liaoning, Shenyang, China.
⁴ School of Computer Science and Engineering, Shenyang University, Shenyang, China.
⁵ Department of Scientific Research and Academic, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Liaoning, Shenyang, China.

Abstract

Purpose: To investigate the use of multiparameter MRI-based radiomics in the in-depth prediction of epidermal growth factor receptor (EGFR) mutation and subtypes based on the spinal metastasis in patients with primary lung adenocarcinoma.

Methods: A primary cohort was conducted with 257 patients who pathologically confirmed spinal bone metastasis from the first center between Feb. 2016 and Oct. 2020. An external cohort was developed with 42 patients from the second center between Apr. 2017 and Jun. 2021. All patients underwent sagittal T1-weighted imaging (T1W) and sagittal fat-suppressed T2-weight imaging (T2FS) MRI imaging. Radiomics features were extracted and selected to build radiomics signatures (RSs). Machine learning classify with 5-fold cross-validation were used to establish radiomics models for predicting the EGFR mutation and subtypes. Clinical characteristics were analyzed with Mann-Whitney U and Chi-Square tests to identify the most important factors. Nomogram models were developed integrating the RSs and important clinical factors.

Results: The RSs derived from T1W showed better performance for predicting the EGFR mutation and subtypes compared with those from T2FS in terms of AUC, accuracy and specificity. The nomogram models integrating RSs from combination of the two MRI sequences and important clinical factors achieved the best prediction capabilities in the training (AUCs, EGFR vs. Exon 19 vs. Exon 21, 0.829 vs. 0.885 vs.0.919), internal validation (AUCs, EGFR vs. Exon 19 vs. Exon 21, 0.760 vs. 0.777 vs.0.811), external validation (AUCs, EGFR vs. Exon 19 vs. Exon 21, 0.780 vs. 0.846 vs.0.818). DCA curves indicated potential clinical values of the radiomics models.

Conclusions: This study indicated potentials of multi-parametric MRI-based radiomics to assess the EGFR mutation and subtypes. The proposed clinical-radiomics nomogram models can be considered as non-invasive tools to assist clinicians in making individual treatment plans.

Keywords: EGFR; MRI; NSCLC; radiomics; spinal metastasis.

Grants and funding

The study was supported by Special foundation for the central government guides the development of local science and technology of Liaoning Province (2018416029), China National Natural Science Foundation (31770147), Natural Science Foundation of Liaoning Province (2021-MS-205) and Medical-Engineering Joint Fund for Cancer Hospital of China Medical University and Dalian University of technology (LD202029).