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  • Associations Between Somati...
    Yip, Stephen S F; Kim, John; Coroller, Thibaud P; Parmar, Chintan; Velazquez, Emmanuel Rios; Huynh, Elizabeth; Mak, Raymond H; Aerts, Hugo J W L

    The Journal of nuclear medicine (1978), 04/2017, Letnik: 58, Številka: 4
    Journal Article

    PET-based radiomics have been used to noninvasively quantify the metabolic tumor phenotypes; however, little is known about the relationship between these phenotypes and underlying somatic mutations. This study assessed the association and predictive power of F-FDG PET-based radiomic features for somatic mutations in non-small cell lung cancer patients. Three hundred forty-eight non-small cell lung cancer patients underwent diagnostic F-FDG PET scans and were tested for genetic mutations. Thirteen percent (44/348) and 28% (96/348) of patients were found to harbor epidermal growth factor receptor (EGFR) or Kristen rat sarcoma viral (KRAS) mutations, respectively. We evaluated 21 imaging features: 19 independent radiomic features quantifying phenotypic traits and 2 conventional features (metabolic tumor volume and maximum SUV). The association between imaging features and mutation status (e.g., EGFR-positive EGFR+ vs. EGFR-negative) was assessed using the Wilcoxon rank-sum test. The ability of each imaging feature to predict mutation status was evaluated by the area under the receiver operating curve (AUC) and its significance was compared with a random guess (AUC = 0.5) using the Noether test. All values were corrected for multiple hypothesis testing by controlling the false-discovery rate (FDR , FDR ) with a significance threshold of 10%. Eight radiomic features and both conventional features were significantly associated with EGFR mutation status (FDR = 0.01-0.10). One radiomic feature (normalized inverse difference moment) outperformed all other features in predicting EGFR mutation status (EGFR+ vs. EGFR-negative, AUC = 0.67, FDR = 0.0032), as well as differentiating between KRAS-positive and EGFR+ (AUC = 0.65, FDR = 0.05). None of the features was associated with or predictive of KRAS mutation status (KRAS-positive vs. KRAS-negative, AUC = 0.50-0.54). Our results indicate that EGFR mutations may drive different metabolic tumor phenotypes that are captured in PET images, whereas KRAS-mutated tumors do not. This proof-of-concept study sheds light on genotype-phenotype interactions, using radiomics to capture and describe the phenotype, and may have potential for developing noninvasive imaging biomarkers for somatic mutations.