Affiliations: [a]
Department of Radiology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
| [b]
Department of Medical Genetics, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
Correspondence:
[*]
Corresponding author: Ezel Yaltırık Bilgin, MD., Department of Radiology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital Mehmet Akif Ersoy Mah. Vatan Cad. No: 91 Yenimahalle Postal code: 06200 Ankara, Turkey. Tel.: +00905324804138; E-mail: ezelyaltirik@yahoo.com; ORCID: 0000-0002-3619-0331.
Note: [1] ORCID: 0000-0001-5024-8918.
Note: [2] ORCID: 0000-0002-2739-6653.
Note: [3] ORCID: 0000-0001-7210-7374.
Abstract: BACKGROUND:The etiology, clinicopathological features, and prognosis of cancer in cases with EGFR mutations are different from those without mutations. OBJECTİVE:This study aims to evaluate the differences in ADC histogram analysis in brain metastases with EGFR mutation status in lung adenocarcinoma cases and the relationship between ADC histogram analysis differences and overall survival. METHODS:In this retrospective case-control study, 30 patients (8 EGFR+/22 EGFR-) and 51 brain metastases (15 EGFR+/36 EGFR-) were included. ROI markings are first performed from each section, including metastasis in ADC mapping using FIREVOXEL software. Next, ADC histogram parameters are calculated. Overall survival analysis after brain metastasis (OSBM) is defined as the time from initial brain metastasis diagnosis to the time of death or last follow-up. Patient-based (by evaluating the largest lesion) and lesion-based (by evaluating all measurable lesions) statistical analyses are then performed. RESULTS:In the lesion-based analysis, skewness values are lower in EGFR+ patients, which is statistically significant (p = 0.012). The two groups have no significant difference regarding other ADC histogram analysis parameters, mortality, and overall survival (p > 0.05). In the ROC analysis, the most appropriate skewness cut-off value is determined as 0.321 to distinguish the EGFR mutation difference, and this value is statistically significant (sensitivity: 66.7%, specificity: 80.6%, AUC: 0.730) (p = 0.006). CONCLUSİON:The findings of this study provide valuable insights into the differences in ADC histogram analysis according to EGFR mutation status in brain metastases due to lung adenocarcinoma. The identified parameters, especially skewness, are potentially non-invasive biomarkers for predicting mutation status. Incorporating these biomarkers into routine clinical practice may aid treatment decision-making and prognostic assessment for patients. Further validation studies and prospective investigations are warranted to confirm the clinical utility of these findings and establish their potential for personalized therapeutic strategies and patient outcomes.
Keywords: ADC, histogram analysis, brain metastasis, Non-small cell lung cancer
