CT texture analysis of lung adenocarcinoma: can Radiomic features be surrogate biomarkers for EGFR mutation statuses

ObjectiveTo investigate whether radiomic features can be surrogate biomarkers for epidermal growth factor receptor (EGFR) mutation statuses.Materials and methodsTwo hundred ninety six consecutive patients, who underwent CT examinations before operation within 3months and had EGFR mutations tested, were enrolled in this retrospective study. CT texture features were extracted using an open-source software with whole volume segmentation. The association between CT texture features and EGFR mutation statuses were analyzed.ResultsIn the 296 patients, there were 151 patients with EGFR mutations (51%). Logistic analysis identified that lower age (Odds Ratio[OR]: 0.968,95% confidence interval [CI]:0.946 similar to 0.990, p=0.005) and a radiomic feature named GreyLevelNonuniformityNormalized (OR: 0.012, 95% CI:0.000 similar to 0.352, p=0.01) were predictors for exon 19 mutation; higher age (OR: 1.027, 95%CI:1.003 similar to 1.052,p=0.025), female sex (OR: 2.189, 95%CI:1.264 similar to 3.791, p=0.005) and a radiomic feature named Maximum2DDiameterColumn (OR: 0.968, 95%CI:0.946 similar to 0.990], p=0.005) for exon 21 mutation; and female sex (OR: 1.883,95%CI:1.064 similar to 3.329, p=0.030), non-smoking status (OR: 2.070, 95%CI:1.090 similar to 3.929, p=0.026) and a radiomic feature termed SizeZone NonUniformityNormalized (OR: 0.010, 95% CI:0.0001 similar to 0.852, p=0.042) for EGFR mutations. Areas under the curve (AUCs) of combination with clinical and radiomic features to predict exon 19 mutation, exon 21 mutation and EGFR mutations were 0.655, 0.675 and 0.664, respectively.ConclusionSeveral radiomic features are associated with EGFR mutation statuses of lung adenocarcinoma. Combination with clinical files, moderate diagnostic performance can be obtained to predict EGFR mutation status of lung adenocarcinoma. Radiomic features might harbor potential surrogate biomarkers for identification of EGRF mutation statuses.