多模态放射组学分析确定与非小细胞肺癌脑转移中表皮生长因子受体突变相关的高一致性预后表型

IF 3.3 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Pub Date : 2025-09-15 DOI:10.1016/j.ejrad.2025.112420

Che-Yu Hsu , Hsin-Han Tsai , Ting-Li Chen , Chih-Hsin Yang , Kao-Lang Liu , Sung-Hsin Kuo , Feng-Ming Hsu , Wei-Wu Chen , Wei-Hsun Hsu , Weichung Wang

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引用次数: 0

摘要

表皮生长因子受体（EGFR）突变与预测复发的放射组学特征之间的有限联系限制了放射组学引导治疗非小细胞肺癌（NSCLC）脑转移（BMs）的应用。本研究旨在建立egfr相关放射组学特征（EGFR-RS），比较其与传统全放射组学特征放射组学特征（WF-RS）的一致性，并评估其在预测放射外科治疗脑转移局部复发中的有效性。方法对2008 ~ 2020年接受放射手术的非小细胞肺癌脑转移患者的脑磁共振（MR）和CT （CT）图像进行分析。最小的绝对收缩和选择算子被用来选择特征和开发签名。使用曲线下面积评估判别能力，而单变量和多变量竞争风险回归确定预测因子并建立临床-放射学模型。结果共纳入318例759例脑转移灶。EGFR-RS纳入了11个MR和6个CT与egfr相关的预后放射学特征，显示出比WF-RS更好的一致性和更好的预测性能，在测试队列中的c指数为0.746 (95% CI 0.616, 0.876)，而WF-RS的c指数为0.655 （95% CI 0.527, 0.784）。多变量分析显示，EGFR-RS是发现组和测试组局部复发的唯一显著预测因子（P < 0.001，风险比[HR] = 2.75; P = 0.01，风险比[HR] = 2.13）。临床放射组学模型（EGFR- rs + EGFR突变状态+ BM大小）在识别局部复发的高危病变方面优于临床模型（发现：P <； 0.001; HR = 4.54；检验：P = 0.002; HR = 5.1）。结论多模态EGFR-RS预测NSCLC脑转移局部复发的一致性优于WF-RS。

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Multimodal radiomic analysis to determine high-Consistency prognostic phenotypes associated with epidermal growth factor receptor mutations in non-small cell lung cancer brain metastases

Introduction

Limited linkage between epidermal growth factor receptor (EGFR) mutations and recurrence–predictive radiomic signatures restricts the application of radiomics–guided therapy for brain metastases (BMs) from non–small–cell lung cancer (NSCLC). This study aimed to establish an EGFR-associated radiomic signature (EGFR-RS), compare its consistency with that of conventional whole radiomic features-based radiomic signature (WF-RS), and evaluate its efficacy in predicting local recurrence for BMs treated with radiosurgery.

Methods

Brain magnetic resonance (MR) and computed tomography (CT) images of NSCLC patients with BMs undergoing radiosurgery between 2008 and 2020 were examined. The least absolute shrinkage and selection operator was utilized to select features and develop signatures. Discriminative abilities were assessed using the area under the curve, while univariable and multivariable competing risk regression determined predictors and established a clinical-radiomic model.

Results

In total, 318 patients with 759 BMs were enrolled. The EGFR-RS, incorporating 11 MR and six CT EGFR-associated prognostic radiomic features, displayed better consistency, and superior predictive performance than the WF-RS, with C-indices of 0.746 (95 %CI 0.616, 0.876) in the test cohort, compared with 0.655 (95 %CI 0.527, 0.784) for the WF-RS. Multivariable analysis indicated EGFR-RS as the sole significant predictor of local recurrence in both the discovery and test sets (P < 0.001, hazard ratio [HR] = 2.75; and P = 0.01, HR = 2.13, respectively). The clinical-radiomic model (EGFR-RS + EGFR mutation status + BM size) outperformed the clinical model in identifying high-risk lesions with local recurrence (discovery: P < 0.001; HR = 4.54; test: P = 0.002; HR = 5.1).

Conclusion

The multimodal EGFR-RS, demonstrating better consistency than the WF-RS, effectively predicted the local recurrence of NSCLC BMs.

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来源期刊

European Journal of Radiology 医学-核医学

CiteScore

6.70

自引率

3.00%

发文量

398

审稿时长

42 days

期刊介绍： European Journal of Radiology is an international journal which aims to communicate to its readers, state-of-the-art information on imaging developments in the form of high quality original research articles and timely reviews on current developments in the field. Its audience includes clinicians at all levels of training including radiology trainees, newly qualified imaging specialists and the experienced radiologist. Its aim is to inform efficient, appropriate and evidence-based imaging practice to the benefit of patients worldwide.