Could Radiomic Signature on Chest CT Predict Epidermal Growth Factor Receptor Mutation in Non-Small-Cell Lung Cancer?

Background: Detecting molecular drivers is crucial in the management of non-small-cell lung cancer (NSCLC). This study aimed to evaluate the use of pretreatment chest computed tomography (CT) radiomics features for predicting epidermal growth factor receptor (EGFR) mutation status in NSCLC. Materials and Methods: CT images were used to develop a radiomics-based model for predicting EGFR mutation status. Two different groups were formed from the dataset, namely groups for training (n = 380) and testing (n = 86). Feature selection was performed using the Least Absolute Shrinkage and Selection Operator (LASSO) algorithm on a radiomics platform. Machine learning methods were then applied to construct the radiomics models. Receiver operating characteristic curve analysis was conducted to assess the performance of the radiomics signature across different datasets and methods. Results: The frequency of EGFR mutation was 13.5% (58/430). A total of 1409 quantitative imaging features were extracted from CT images using the Radcloud platform. Among the six radiomics-based classifiers (k-Nearest Neighbor, Support Vector Machine (SVM), eXtreme Gradient Boosting, Random Forest, Logistic Regression, and Decision Tree), SVM demonstrated the highest area under the curve values in both the testing and training groups, reaching 0.87 and 0.98, respectively. Our model, which incorporated both clinical and radiomics data, successfully predicted EGFR mutation status with an accuracy rate of 86.9%. Conclusion: Our findings highlight the potential of radiomics features as a non-invasive predictive imaging biomarker for EGFR mutation status, which could enhance personalized treatment in NSCLC. Radiomics emerges as a valuable tool for identifying driver mutations, although further studies are necessary to validate its clinical utility in NSCLC.