title: CT Radiogenomic Characterization of EGFR, K-RAS, and ALK Mutations in Non-Small Cell Lung Cancer.
abstract: OBJECTIVE
  To assess the association between CT features and EGFR, ALK, KRAS mutations in non-small cell lung cancer.
  
  
  METHODS
  Patients undergoing chest CT and testing for the above gene mutations were included. Qualitative evaluation of CTs included: lobe; lesion diameter; shape; margins; ground-glass opacity; density; cavitation; air bronchogram; pleural thickening; intratumoral necrosis; nodules in tumour lobe; nodules in non-tumour lobes; pleural retraction; location; calcifications; emphysema; fibrosis; pleural contact; pleural effusion. Statistical analysis was performed to assess association of features with each gene mutation. ROC curves for gene mutations were drawn; the corresponding area under the curve was calculated. P-values <0.05 were considered significant.
  
  
  RESULTS
  Of 285 patients, 60/280 (21.43 %) were positive for EGFR mutation; 31/270 (11.48 %) for ALK rearrangement; 64/240 (26.67 %) for KRAS mutation. EGFR mutation was associated with air bronchogram, pleural retraction, females, non-smokers, small lesion size, and absence of fibrosis. ALK rearrangements were associated with age and pleural effusion. KRAS mutation was associated with round shape, nodules in non-tumour lobes, and smoking.
  
  
  CONCLUSIONS
  This study disclosed associations between CT features and alterations of EGFR (air bronchogram, pleural retraction, small lesion size, absence of fibrosis), ALK (pleural effusion) and KRAS (round lesion shape, nodules in non-tumour lobes).
  
  
  CONCLUSIONS
  Air bronchogram, pleural retraction, small size relate to EGFR mutation in NSCLC. Pleural effusion and younger age relate to ALK mutation. Round lesion shape, nodules in non-tumour lobes relate to KRAS mutation.
authors.affiliation: Department of Radiology, European Institute of Oncology, via Ripamonti 435, 20141, Milan, Italy. stefania.rizzo@ieo.it.
authors.forename: Stefania
authors.initials: S
authors.lastname: Rizzo
authors.affiliation: Department of Thoracic Surgery, European Institute of Oncology, via Ripamonti 435, 20141, Milan, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Petrella
authors.affiliation: Department of Health Sciences, University of Milan, via A. di Rudinì 8, 20142, Milan, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Buscarino
authors.affiliation: Department of Health Sciences, University of Milan, via A. di Rudinì 8, 20142, Milan, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: De Maria
authors.affiliation: Department of Epidemiology and Biostatistics, European Institute of Oncology, via Ramusio, 1, 20141, Milan, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Raimondi
authors.affiliation: Department of Pathology, European Institute of Oncology, via Ripamonti 435, 20141, Milan, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Barberis
authors.affiliation: Department of Pathology, European Institute of Oncology, via Ripamonti 435, 20141, Milan, Italy.
authors.forename: Caterina
authors.initials: C
authors.lastname: Fumagalli
authors.affiliation: Department of Thoracic Oncology, European Institute of Oncology, via Ripamonti 435, 20141, Milan, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Spitaleri
authors.affiliation: Department of Radiology, European Institute of Oncology, via Ripamonti 435, 20141, Milan, Italy.
authors.forename: Cristiano
authors.initials: C
authors.lastname: Rampinelli
authors.affiliation: Department of Thoracic Oncology, European Institute of Oncology, via Ripamonti 435, 20141, Milan, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: De Marinis
authors.affiliation: Department of Thoracic Surgery, European Institute of Oncology, via Ripamonti 435, 20141, Milan, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Spaggiari
authors.affiliation: Department of Radiology, European Institute of Oncology, via Ripamonti 435, 20141, Milan, Italy.|Department of Health Sciences, University of Milan, via A. di Rudinì 8, 20142, Milan, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Bellomi
mesh_terms: D000368:Aged; D000077548:Anaplastic Lymphoma Kinase; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging / Q000235:genetics*; D066246:ErbB Receptors / Q000235:genetics*; D005260:Female; D015321:Gene Rearrangement / Q000235:genetics; D011905:Genes, ras / Q000235:genetics*; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000235:genetics*; D008297:Male; D009154:Mutation / Q000235:genetics*; D010996:Pleural Effusion / Q000000981:diagnostic imaging / Q000235:genetics; D012372:ROC Curve; D020794:Receptor Protein-Tyrosine Kinases / Q000235:genetics*; D012907:Smoking / Q000235:genetics; D014057:Tomography, X-Ray Computed
chemical_list: C000626173:ALK protein, human; C000626175:Alk protein, rat; D000077548:Anaplastic Lymphoma Kinase; D066246:ErbB Receptors; D020794:Receptor Protein-Tyrosine Kinases
keywords: Anaplastic lymphoma kinase (ALK); Computed Tomography (CT); Epidermal growth factor receptor (EFGR); Kirsten rat sarcoma (KRAS); Non-small cell lung carcinoma (NSCLC)