Article Figures & Data
Figures
- Fig 1.
Representative MR images depicting visual scores based on diffusion-weighted imaging findings for brain metastasis from lung cancer. Contrast-enhanced T1-weighted images show an apparent enhanced tumor in the left frontal lobe (A1), left parietal lobe (B1), and right parietal lobe (C1). T2-weighted images (A2, B2, and C2) show varying degrees of peritumoral brain edema. A3, BM is not detectable on DWI (A3, score = 1). B3 and C3, DWI images show iso-signal intensity (score = 2) and high signal intensity (score = 3), respectively, relative to the normal-appearing cortical gray matter.
- Fig 2.
Representative images depicting the ROI within a tumor and the corresponding contralateral normal-appearing white matter for the calculation of apparent diffusion coefficient values for brain metastasis lesions stratified by the EGFR mutation status. A1 and B1, Contrast-enhanced T1-weighted images show contrast enhancement of the metastasis. A2 and B2, Diffusion-weighted images show mild-to-moderate high signal intensity in the contrast-enhanced areas. A3 and B3, ADC map with ROIs within the tumor and corresponding contralateral normal-appearing white matter. A1–A3, Wild type EGFR. B1–B3, EGFR mutation–positive.
- Fig 3.
Boxplot for minimum apparent diffusion coefficient (A) and normalized ADC ratio (B) values for patients with lung adenocarcinoma with wild type EGFR, mutations in exon 19 and/or 21, and mutations in exon 20. Asterisk indicates statistically significant.
Tables
Total (n = 74) Adenocarcinoma (n = 56) Small-Cell Lung Cancer (n = 11) Squamous Cell Carcinoma (n = 7) P Value DWI visual score 1.87 ± 0.76 2.27 ± 0.90 1.85 ± 0.69 .298 ADCmin (×10−6mm2/s) 615.23 ± 166.83 623.38 ± 163.07 531.18 ± 160.54 682.14 ± 182.07 .131 nADC ratio 1.02 ± 0.28 1.04 ± 0.28 0.88 ± 0.2 1.11 ± 0.28 .144 Age (yr) 64.19 ± 10.76 63.63 ± 11.15 68.09 ± 9.14 62.57 ± 9.73 .420 Male sex 50 (67.57) 36 (64.29) 9 (81.82) 5 (71.43) .587 Site of BM .545 Anterior circulation—dominanta 25 (33.78) 21 (37.5) 2 (18.18) 2 (28.57) Posterior circulation—dominantb 11 (14.86) 7 (12.5) 2 (18.18) 2 (28.57) Even distribution 38 (51.35) 28 (50) 7 (63.64) 3 (42.86) No. of BMs .051 1 18 (24.32) 16 (28.57) 0 (0) 2 (28.57) 1<BM<10 43 (58.11) 32 (57.14) 6 (54.55) 5 (71.43) ≥10 13 (17.57) 8 (14.29) 5 (45.45) 0 (0) Target lesion size of BM .367 <10 mm 31 (41.89) 22 (39.29) 7 (63.64) 2 (28.57) 10 mm≤BM<30 mm 32 (43.24) 24 (42.86) 3 (27.27) 5 (71.43) ≥30 mm 11 (14.86) 10 (17.86) 1 (9.09) 0 (0) Intratumoral necrosis 32 (43.24) 21 (37.5) 6 (54.55) 5 (71.43) .160 Intratumoral hemorrhage 15 (20.27) 11 (19.64) 3 (27.27) 1 (14.29) .882 - Table 2:
Comparison of ADCmin values and normalized ADC ratio according to gene mutation status in adenocarcinoma group
Wild Type Mutation P Value EGFR 29 (52.7) 26 (47.3) DWI visual score 1.92 ± 0.77 1.87 ± 0.76 .179 ADCmin (×10−6mm2/s) 674.55 ± 182.78 575.85 ± 115.01 .021 nADC ratio 1.13 ± 0.32 0.95 ± 0.19 .014 Alk 25 (86.2) 4 (13.8) DWI visual score 1.96 ± 0.79 2 ± 1.15 .930 ADCmin (×10−6mm2/s) 583.8 ± 183.84 562 ± 159.12 .825 nADC ratio 1 ± 0.34 0.83 ± 0.19 .328 Kras 29 (90.6) 3 (9.4) DWI visual score 1.82 ± 0.77 2.33 ± 0.57 .274 ADCmin (×10−6mm2/s) 641.31 ± 168.32 631.45 ± 161.74 .310 nADC ratio 1.08 ± 0.31 1.08 ± 0.32 .926 Predictors EGFR Mutation (Exon 19 + 20 + 21) EGFR Mutation (Exon 19 + 21) OR (95% CI) P Value OR (95% CI) P Value Female sex 1.630 (0.539–4.927) .387 1.538 (0.483–4.898) .466 Age, per 1-yr increase 0.975 (0.928–1.024) .307 0.972 (0.923–1.024) .282 Site of BM Anterior circulation–dominanta Reference Reference Posterior circulation–dominantb 0.750 (0.132–4.250) .745 0.833 (0.145–4.781) .837 Even distribution 0.867 (0.275–2.734) .807 0.741 (0.222–2.471) .625 No. of BM 1 Reference Reference 1<BM<10 1.765 (0.491–6.337) .383 1.765 (0.446–6.979) .418 ≥10 6.000 (0.873–41.214) .068 7.500 (1.039–54.116) .045 Target lesion size of BM <10 mm Reference Reference 10 mm≤BM<30 mm 1.015 (0.318–3.243) .979 0.923 (0.275–3.102) .897 ≥30 mm 1.500 (0.315–7.135) .61 1.333 (0.260–6.828) .729 Intratumoral necrosis 1.188 (0.395–3.569) .759 0.887 (0.273–2.884) .841 Intratumoral hemorrhage 1.440 (0.382–5.428) .59 1.412 (0.353–5.649) .625 Diffusion visual scoring 1.630 (0.680–2.601) .199 1.514 (0.722–2.974) .274 ADCmin 0.996 (0.992–1.000) .028 0.995 (0.991–0.999) .020 nADC ratio 0.064 (0.006–0.666) .021 0.044 (0.004–0.563) .016
