title: Predictive radiogenomics modeling of EGFR mutation status in lung cancer.
abstract: Molecular analysis of the mutation status for EGFR and KRAS are now routine in the management of non-small cell lung cancer. Radiogenomics, the linking of medical images with the genomic properties of human tumors, provides exciting opportunities for non-invasive diagnostics and prognostics. We investigated whether EGFR and KRAS mutation status can be predicted using imaging data. To accomplish this, we studied 186 cases of NSCLC with preoperative thin-slice CT scans. A thoracic radiologist annotated 89 semantic image features of each patient's tumor. Next, we built a decision tree to predict the presence of EGFR and KRAS mutations. We found a statistically significant model for predicting EGFR but not for KRAS mutations. The test set area under the ROC curve for predicting EGFR mutation status was 0.89. The final decision tree used four variables: emphysema, airway abnormality, the percentage of ground glass component and the type of tumor margin. The presence of either of the first two features predicts a wild type status for EGFR while the presence of any ground glass component indicates EGFR mutations. These results show the potential of quantitative imaging to predict molecular properties in a non-invasive manner, as CT imaging is more readily available than biopsies.
authors.affiliation: Stanford Center for Biomedical Informatics Research, Department of Medicine &Department of Biomedical Data Science, Stanford University, Stanford, CA, USA.
authors.forename: Olivier
authors.initials: O
authors.lastname: Gevaert
authors.affiliation: Department of Radiology, Stanford University, Stanford, CA, USA.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Echegaray
authors.affiliation: Thoracic and GI Oncology Branch, CCR, National Institutes of Health, National Cancer Institute, Bethesda, MD, USA.
authors.forename: Amanda
authors.initials: A
authors.lastname: Khuong
authors.affiliation: Thoracic and GI Oncology Branch, CCR, National Institutes of Health, National Cancer Institute, Bethesda, MD, USA.
authors.forename: Chuong D
authors.initials: CD
authors.lastname: Hoang
authors.affiliation: Thoracic and GI Oncology Branch, CCR, National Institutes of Health, National Cancer Institute, Bethesda, MD, USA.
authors.forename: Joseph B
authors.initials: JB
authors.lastname: Shrager
authors.affiliation: Department of Pathology, Stanford University Medical Center, Stanford, CA, USA.|Pathology and Laboratory Service of Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA.
authors.forename: Kirstin C
authors.initials: KC
authors.lastname: Jensen
authors.affiliation: Department of Pathology, Stanford University Medical Center, Stanford, CA, USA.
authors.forename: Gerald J
authors.initials: GJ
authors.lastname: Berry
authors.affiliation: Department of Radiology, Stanford University, Stanford, CA, USA.
authors.forename: H Henry
authors.initials: HH
authors.lastname: Guo
authors.affiliation: Department of Radiology, Stanford University, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA.
authors.forename: Charles
authors.initials: C
authors.lastname: Lau
authors.affiliation: Department of Radiology, Stanford University, Stanford, CA, USA.
authors.forename: Sylvia K
authors.initials: SK
authors.lastname: Plevritis
authors.affiliation: Department of Radiology, Stanford University, Stanford, CA, USA.
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Rubin
authors.affiliation: Department of Radiology, Stanford University, Stanford, CA, USA.
authors.forename: Sandy
authors.initials: S
authors.lastname: Napel
authors.affiliation: Department of Radiology, Stanford University, Stanford, CA, USA.
authors.forename: Ann N
authors.initials: AN
authors.lastname: Leung
mesh_terms: D019540:Area Under Curve; D014408:Biomarkers, Tumor; D003663:Decision Trees; D066246:ErbB Receptors / Q000235:genetics*; D005260:Female; D023281:Genomics / Q000379:methods; D006801:Humans; D008175:Lung Neoplasms / Q000235:genetics* / Q000473:pathology; D008297:Male; D015999:Multivariate Analysis; D009154:Mutation; D016283:Proto-Oncogene Proteins p21(ras) / Q000235:genetics
chemical_list: D014408:Biomarkers, Tumor; C117307:KRAS protein, human; D066246:ErbB Receptors; D016283:Proto-Oncogene Proteins p21(ras)