Epidermal growth factor receptor mutations in lung adenocarcinoma: associations between dual-energy spectral CT measurem
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ORIGINAL ARTICLE – CLINICAL ONCOLOGY
Epidermal growth factor receptor mutations in lung adenocarcinoma: associations between dual‑energy spectral CT measurements and histologic results Guojin Zhang1,2,3 · Yuntai Cao1,2,3 · Jing Zhang1,2 · Zhiyong Zhao1,2 · Wenjuan Zhang1,2 · Junlin Zhou2,3 Received: 6 August 2020 / Accepted: 19 September 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Objective To analyze the relationship between dual-energy spectral CT and epidermal growth factor receptor (EGFR) mutation status in patients with lung adenocarcinoma. Methods The quantitative parameters of spectral CT were analyzed in 208 patients with lung adenocarcinoma. The quantitative parameters including C T40keV and C T70keV values, effective atomic number (Zeff), iodine concentration (IC), water concentration (WC), and the slope of the spectral curve (λ HU) were calculated. Statistical analysis was used to determine the clinical characteristics and quantitative parameters for the diagnosis of EGFR-mutation status. The ROC curves were used to calculate diagnostic efficiency. Results Sex (p = 0.027) and smoking history (p = 0.019) differed significantly according to the EGFR-mutation status. Spectral CT quantitative parameters ( CT40keV and C T70keV values, λ HU, Zeff and IC) differed significantly between the EGFR mutant and the EGFR wild-type groups (p 0.05). ROC curve analysis revealed the combination of the significantly different quantitative parameters provided the best diagnostic performance for determining the EGFR-mutation status (AUC: 76.0%) in the AP, while the AUC during the VP was 75.6%. Conclusion The quantitative parameters of dual-energy spectral CT have potential value for identifying the EGFR-mutation status. Keywords Lung adenocarcinoma · Epidermal growth factor receptor · Spectral computed tomography
Introduction The morbidity and mortality of lung cancer remain the highest among all malignancies worldwide, accounting for an incidence of 2.2 million cases and 1.9 million deaths in Guojin Zhang, Yuntai Cao, and Junlin Zhou have contributed equally to this work. * Junlin Zhou [email protected] 1
Second Clinical School, Lanzhou University, Lanzhou, China
2
Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China
3
Department of Radiology, Lanzhou University Second Hospital, Chengguan District, Cuiyingmen No.82, Lanzhou 730030, People’s Republic of China
2017, respectively (Global Burden of Disease Cancer et al. 2018). Non-small cell lung cancer (NSCLC) accounts for more than 80% of cases of lung cancer, and adenocarcinoma is the most common histopathological type (Hsu et al. 2018). In the past decade, great progress has been made in research on the pathological analysis and molecular biology of lung cancer, especially NSCLC (Chen et al. 2014). NSCLC is defined as a heterogeneous condition (Kerr 2009; Travis 2009). Recently, epidermal growth factor receptor (EGFR) was a key molecule in investigation of lung adenocarcinoma (Liu et al. 201
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