Epidermal growth factor receptor mutations in lung adenocarcinoma: associations between dual-energy spectral CT measurements and histologic results.

Abstract

To analyze the relationship between dual-energy spectral CT and epidermal growth factor receptor (EGFR) mutation status in patients with lung adenocarcinoma. The quantitative parameters of spectral CT were analyzed in 208 patients with lung adenocarcinoma. The quantitative parameters including CT40keV and CT70keV 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. Sex (p = 0.027) and smoking history (p = 0.019) differed significantly according to the EGFR-mutation status. Spectral CT quantitative parameters (CT40keV and CT70keV values, λ HU, Zeff and IC) differed significantly between the EGFR mutant and the EGFR wild-type groups (p < 0.05) during the arterial phase (AP) and venous phase (VP). However, WC was not statistically different between the two 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%. The quantitative parameters of dual-energy spectral CT have potential value for identifying the EGFR-mutation status.