Correlation Between EGFR Mutation Status and Computed Tomography Features in Patients With Advanced Pulmonary Adenocarcinoma

Purpose: To correlate computed tomography (CT) imaging features and epidermal growth factor receptor (EGFR) mutation status in patients with advanced lung adenocarcinoma. Materials and Methods: Patients with advanced pulmonary adenocarcinoma who were diagnosed between January 1, 2009 and December 31, 2011 and who had available chest CT and their tumors analyzed for EGFR mutations at a university hospital were enrolled in this retrospective study. Two radiologists independently evaluated the CT images and recorded the target lesion's size, shape, margin, density, and the presence or absence of an air bronchogram and calcification. Results: One hundred and forty-nine patients were enrolled into this study (66 men, 83 women), with a mean age of 63 +/- 11 years (range 32 to 89 y). Seventy-eight (52.3%) patients had EGFR mutations. The tumors in the patients harboring no EGFR mutations (EGFR wild type) were larger than in those whose tumors harbored EGFR mutations (P = 0.01). An irregular shape was more common in the tumors with wild-type EGFR (P = 0.01), and an oval shape was more common in tumors with EGFR mutations. Tumors with exon 21 mutations were larger than those with exon 19 deletions (P = 0.02). Air bronchograms were more common in tumors with exon 19 deletions than in those with wild-type EGFR or exon 21 mutations (P = 0.004 and 0.01, respectively). Calcification was more common in the tumors with wild-type EGFR than in those with EGFR mutations (P = 0.03). Conclusions: Adenocarcinomas with wild-type EGFR were significantly associated with larger tumors and an irregular shape. In particular, calcification was more common in the tumors with wildtype EGFR than in those with EGFR mutations. In addition, air bronchograms were more common in the tumors with exon 19 deletions.