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72PD MR Imaging Radiomics of NSCLC Brain Metastases: A Potential Targetable Imaging Biomarker for EGFR Status

In Journal of Thoracic Oncology
By: Mahajan A.
Contributor(s): Prabhash K | Ghaytidak A | Noronah V | Joshi A | Patil V.
Material type: materialTypeLabelArticlePublisher: 2018Description: .Subject(s): EGFR | MRI Imaging | NSCLC In: Journal of Thoracic Oncology Vol. 13, suppl_4, p. S39-S40Summary: Background: Brain is a common site of metastases withEGFR mutated lung cancer. Oral targeted therapies havebroadened the treatment options in the advanced settingwith the potential for periods of long term response.Literature on MR imaging metrics or feature analysisof NSCLC brain metastasis as a biomarker for predictingEGFR mutation is limited and less investigated. Thepurpose of the study was to study MRI imagingbiomarkers of brain metastases NSCLC and their correl-ation with molecular subtyping (EFGR status). Tocorrelate these imaging features with response totherapy and clinical outcomes.Methods: We analyzed clinical data on 75 patients whowere tested for EGFR mutation and underwent brainMR imaging at diagnosis. Multiparametric MRI wasperformed in all cases. The associations between EGFRmutation status and clinical features, specifically age, sex,smoking, TNM stage, and imaging variables, as well asbrain metastasis, were analyzed using logistic regressionanalysis. Clinical factors known to be associated withEGFR mutation status in NSCLC patients and stagingfactors of TNM were included in the logistic regressionmultivariate analysis.Results: 38 EGFR positive and 37 EGFR negative cases.EGFR positive showed early and wide spread develop-ment of brain metastasis (within 6 months after 1stpresentation) (p-0.00). Statistically significant difference(p-0.00) was observed in border/margins on T2W imaging, fuzzy and in filtrative borders in EGFR positive while well defined in EGFR negative. Lesions in EGFR wild group showed focal restriction on DW images (p-0.001).In EGFR wild cases showed good response to WBRT (p <0.00). Incidence of recurrent metastatic disease, menin-geal involvement was significantly higher in EGFRpositive (p-0.00, 0.04). On multivariate analysis, statis-tically significant association was found between T2 border, number, restricted diffusion, meningeal positivity and TTP (p < 0.05).Conclusions: EGFR positive brain metastases have characteristic MR imaging features that can be potential non-invasive diagnostic, predictive and prognosticimaging biomarkers. These MR based Radiogenomic imaging biomarkers have potential role in personalizedtherapy of EGFR positive brain metastasis in NSCLC. Legal entity responsible for the study: IEC TMH Funding: Has not received any funding Disclosure: All authors have declared no conflicts of interest.
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Background: Brain is a common site of metastases withEGFR mutated lung cancer. Oral targeted therapies havebroadened the treatment options in the advanced settingwith the potential for periods of long term response.Literature on MR imaging metrics or feature analysisof NSCLC brain metastasis as a biomarker for predictingEGFR mutation is limited and less investigated. Thepurpose of the study was to study MRI imagingbiomarkers of brain metastases NSCLC and their correl-ation with molecular subtyping (EFGR status). Tocorrelate these imaging features with response totherapy and clinical outcomes.Methods: We analyzed clinical data on 75 patients whowere tested for EGFR mutation and underwent brainMR imaging at diagnosis. Multiparametric MRI wasperformed in all cases. The associations between EGFRmutation status and clinical features, specifically age, sex,smoking, TNM stage, and imaging variables, as well asbrain metastasis, were analyzed using logistic regressionanalysis. Clinical factors known to be associated withEGFR mutation status in NSCLC patients and stagingfactors of TNM were included in the logistic regressionmultivariate analysis.Results: 38 EGFR positive and 37 EGFR negative cases.EGFR positive showed early and wide spread develop-ment of brain metastasis (within 6 months after 1stpresentation) (p-0.00). Statistically significant difference(p-0.00) was observed in border/margins on T2W imaging, fuzzy and in filtrative borders in EGFR positive while well defined in EGFR negative. Lesions in EGFR wild group showed focal restriction on DW images (p-0.001).In EGFR wild cases showed good response to WBRT (p <0.00). Incidence of recurrent metastatic disease, menin-geal involvement was significantly higher in EGFRpositive (p-0.00, 0.04). On multivariate analysis, statis-tically significant association was found between T2 border, number, restricted diffusion, meningeal positivity and TTP (p < 0.05).Conclusions: EGFR positive brain metastases have characteristic MR imaging features that can be potential non-invasive diagnostic, predictive and prognosticimaging biomarkers. These MR based Radiogenomic imaging biomarkers have potential role in personalizedtherapy of EGFR positive brain metastasis in NSCLC. Legal entity responsible for the study: IEC TMH Funding: Has not received any funding Disclosure: All authors have declared no conflicts of interest.

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