Background: Leveraging the radiomics information from non-small cell lung cancer (NSCLC) primary lesion and brain metastasis (BM) to develop and validate a bimodal radiomics nomogram that can accurately predict epidermal growth factor receptor (EGFR) status. Methods: A total of 309 NSCLC patients with BM from three independent centers were recruited. Among them, the patients of Center I were randomly allocated into the training and internal test cohorts in a 7:3 ratio. Meanwhile, the patients from Center II and Center III collectively constitute the external test cohort. All chest CT and brain MRI images of each patient were obtained for image registration and sequence combination within a single modality. After image preprocessing, 1037 radiomics features were extracted from each single sequence. Six machine learning algorithms were used to construct radiomics signatures for CT and MRI respectively. The best CT and MRI radiomics signatures were fitted to establish the bimodal radiomics nomogram for predicting the EGFR status. Results: The contrast-enhanced (CE) eXtreme gradient boosting (XG Boost) and T2-weighted imaging (T2WI) + T1-weighted contrast-enhanced imaging (T1CE) random forest models were chosen as the radiomics signature representing primary lesion and BM. Both models were found to be independent predictors of EGFR mutation. The bimodal radiomics nomogram, which incorporated CT radiomics signature and MRI radiomics signature, demonstrated a good calibration and discrimination in the internal test cohort [area under curve (AUC), 0.866; 95 % confidence intervals (CI), 0.778-0.950) and the external test cohort (AUC, 0.818; 95 % CI, 0.691-0.938). Conclusions: Our CT and MRI bimodal radiomics nomogram could timely and accurately evaluate the likelihood of EGFR mutation in patients with limited access to necessary materials, thus making up for the shortcoming of plasma sequencing and promoting the advancement of precision medicine.
[1]Kunming Med Univ, Yan An Hosp Kunming City, Yanan Hosp, Dept Radiol, 245 Renmin East Rd, Kunming, Yunnan, Peoples R China.
[2]Kunming Med Univ, Yunnan Canc Hosp, Affiliated Hosp 3, Bidding & Procurement Off, 519 Kunzhou Rd, Kunming, Yunnan, Peoples R China.
[3]Univ Calif Riverside, Dept Chem, 900 Univ Ave, Riverside, CA USA.
[4]Kunming Univ Sci & Technol, Peoples Hosp Yunnan Prov 1, Affiliated Hosp, Dept Med Imaging, 157 Jinbi Rd, Kunming, Yunnan, Peoples R China.
[5]Kunming Med Univ, Yunnan Canc Hosp, Affiliated Hosp 3, Dept Thorac Surg, 519 Kunzhou Rd, Kunming, Yunnan, Peoples R China.
[6]Kunming Med Univ, Affiliated Hosp 2, Dept Thorac Surg, 374 Dianmian Ave, Kunming, Yunnan, Peoples R China.
[7]Kunming Med Univ, Yunnan Canc Hosp, Affiliated Hosp 3, Dept Radiol, 519 Kunzhou Rd, Kunming, Yunnan, Peoples R China.
[8]Kunming Med Univ, Affiliated Hosp 1, Dept Radiol, 295 Xichang Rd, Kunming, Yunnan, Peoples R China.
(8.0+极速模式)