Predicting the Presence of Targetable Molecular Alteration(s) With Clinico-metabolic 18F-FDG PET Radiomics in Non-Asian Lung Adenocarcinoma Patients [post]

Nicolas Aide, Kathleen Weys, Charline LASNON
2021 unpublished
PurposeTo investigate if combining clinical characteristics with pre-therapeutic 18F-FDG PET radiomics could predict the presence of molecular alteration(s) in key molecular targets in lung adenocarcinoma in order to screen patients who are more likely to benefit from a tumoral molecular analysis. MethodsThis non-interventional mono-centric study prospectively included patients with newly-diagnosed lung adenocarcinoma referred for baseline PET and who had tumoral molecular analyses for the
more » ... alyses for the following targets: EGFR, BRAF, KRAS, NRAS, MET, STK11, PIK3CA, ALK and ROS1. Tumoral volumes of interest were analysed using LifeX software. A logistic regression was performed, including sex, age, smoking history, AJCC stage and thirty-one PET variables. A validation process was used by randomly splitting the data in training and validation datasets.ResultsEighty-seven patients were analysed. Forty-seven patients (54.0%) had at least one molecular alteration. Using the training dataset (n=67), five variables were included in the logit model: age, sex, AJCC stage, correlation_GLCM and GLNU_GLZLM. More molecular alterations were observed in women: 88.0% in women versus 40.3% in men (p<0.0001). Other clinical and PET variables were not different between patients with and without molecular alterations. There was a moderate correlation between correlation_GLCM and GLNU_GLZLM (p <0.0001, ρ = 0.591). The ROC analysis for molecular alteration prediction using this model found an area under the curve equal to 0.891 (p<0.0001). A cut-off value set to 0.38 led to a sensitivity of 97.4%, a negative predictive value of 80.4% and a LR+ equal to 3.1. When applying this cut-off value in the validation dataset of patients (n=20), the test presented a sensitivity equal to 88.9%, a NPV equal to 87.5% and a LR+ = 2.4. ConclusionsA clinico-metabolic 18F-FDG PET phenotype allows detecting key molecular target alterations with high sensitivity and NPV thus opens the way to the selection of patients for molecular analysis.
doi:10.21203/ fatcat:tlriciynqnbyhb74sldkxi3t6q