The Utility and Efficiency of Diffusion Tensor Imaging Values to Determine Epidermal Growth Factor Receptor Gene Mutation Status in Brain Metastasis from Lung Adenocarcinoma; A Preliminary Study

Title:The Utility and Efficiency of Diffusion Tensor Imaging Values to Determine Epidermal Growth Factor Receptor Gene Mutation Status in Brain Metastasis from Lung Adenocarcinoma; A Preliminary Study

Volume: 16

Author(s): Mehmet Ali Gultekin*, Hacı Mehmet Turk, Ismail Yurtsever, Bahar Atasoy, Altay Aliyev, Temel Fatih Yilmaz and Alpay Alkan

Affiliation:

• Department of Radiology, Faculty of Medicine, Bezmialem Vakif University, Istanbul,Turkey

Keywords: Lung adenocarcinoma, brain metastases, EGFR, diffusion tensor imaging, ADC, axial diffusivity.

Abstract:

Background: This study aims to investigate the existence of any Diffusion Tensor Imaging (DTI) value differences in Brain Metastases (BM) due to lung adenocarcinoma based on the Epidermal Growth Factor Receptor (EGFR) gene mutation status.

Material and Methods: 17 patients with 32 solid intracranial metastatic lesions from lung adenocarcinoma were included prospectively. Patients were divided according to the EGFR mutation status as EGFR (+) (group 1, n:8) and EGFR wild type (group 2, n:9). The Fractional Anisotropy (FA), apparent diffusion coefficient (ADC), normalized ADC (nADC), Axial Diffusivity (AD), and Radial Diffusivity (RD) values were measured from the solid component of the metastatic lesions and nADC values were calculated. DTI values were compared between group 1 and group 2. The receiver-operating characteristic analysis was used to obtain cut-off values for the parameters presenting a statistical difference between the EGFR gene mutation-positive and wild type group.

Results: There were statistically significant differences in measured ADC, nADC, AD, and RD values between group 1 and group 2. The ADC, nADC, AD, and RD values were significantly lower in group 1. There was no significant difference in FA values between the two groups. Analysis by the ROC curve method revealed a cut-off value of ≤721 x 10-6 mm2/s for ADC (Sensitivity= 72.7, Specificity=85.7); ≤0.820 for nADC (Sensitivity=72.7, Specificity=90.5), ≤ 886 for AD (Sensitivity=81.8, Specificity=81.0), and ≤588 for RD (Sensitivity=63.6, Specificity=90.5) in differentiating EGFR mutation (+) group from wild type group.

Conclusion: A combination of the decreased ADC, nADC, AD, and RD values in BM due to lung adenocarcinoma can be important for predicting the EGFR gene mutation status. DTI features of the brain metastases from lung adenocarcinoma may be utilized to provide insight into the EGFR mutation status and guide the clinicians for the initiation of targeted therapy.

Cite this article as:

Gultekin Ali Mehmet *, Turk Mehmet Hacı , Yurtsever Ismail , Atasoy Bahar , Aliyev Altay , Yilmaz Fatih Temel and Alkan Alpay , The Utility and Efficiency of Diffusion Tensor Imaging Values to Determine Epidermal Growth Factor Receptor Gene Mutation Status in Brain Metastasis from Lung Adenocarcinoma; A Preliminary Study, Current Medical Imaging 2020; 16 (10) . https://dx.doi.org/10.2174/1573405615666191122122207

DOI https://dx.doi.org/10.2174/1573405615666191122122207	Print ISSN 1573-4056
Publisher Name Bentham Science Publisher	Online ISSN 1875-6603