BACKGROUND:The etiology, clinicopathological features, and prognosis of cancer in cases with EGFR mutations are different from those without mutations. OBJECTİVE:This study aims to evaluate the differences in ADC histogram analysis in brain metastases with EGFR mutation status in lung adenocarcinoma cases and the relationship between ADC histogram analysis differences and overall survival. METHODS:In this retrospective case-control study, 30 patients (8 EGFR+/22 EGFR-) and 51 brain metastases (15 EGFR+/36 EGFR-) were included. ROI markings are first performed from each section, including metastasis in ADC mapping using FIREVOXEL software. Next, ADC histogram parameters are calculated. Overall survival analysis after brain metastasis (OSBM) is defined as the time from initial brain metastasis diagnosis to the time of death or last follow-up. Patient-based (by evaluating the largest lesion) and lesion-based (by evaluating all measurable lesions) statistical analyses are then performed. RESULTS:In the lesion-based analysis, skewness values are lower in EGFR+ patients, which is statistically significant (p = 0.012). The two groups have no significant difference regarding other ADC histogram analysis parameters, mortality, and overall survival (p > 0.05). In the ROC analysis, the most appropriate skewness cut-off value is determined as 0.321 to distinguish the EGFR mutation difference, and this value is statistically significant (sensitivity: 66.7%, specificity: 80.6%, AUC: 0.730) (p = 0.006). CONCLUSİON:The findings of this study provide valuable insights into the differences in ADC histogram analysis according to EGFR mutation status in brain metastases due to lung adenocarcinoma. The identified parameters, especially skewness, are potentially non-invasive biomarkers for predicting mutation status. Incorporating these biomarkers into routine clinical practice may aid treatment decision-making and prognostic assessment for patients. Further validation studies and prospective investigations are warranted to confirm the clinical utility of these findings and establish their potential for personalized therapeutic strategies and patient outcomes.

中文翻译：

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肺腺癌脑转移中EGFR突变状态表观扩散系数直方图分析的差异

背景：EGFR突变患者的癌症病因、临床病理特征和预后与非EGFR突变患者不同。目的：本研究旨在评估肺腺癌病例中EGFR突变状态的脑转移瘤ADC直方图分析差异以及ADC直方图分析差异与总生存率之间的关系。方法：在这项回顾性病例对照研究中，纳入了 30 例患者（8 例 EGFR+/22 EGFR-）和 51 例脑转移瘤患者（15 例 EGFR+/36 EGFR-）。首先对每个部分进行 ROI 标记，包括使用 FIREVOXEL 软件进行 ADC 映射中的转移。接下来，计算 ADC 直方图参数。脑转移后总体生存分析（OSBM）定义为从最初诊断脑转移到死亡或最后一次随访的时间。然后进行基于患者（通过评估最大病变）和基于病变（通过评估所有可测量病变）的统计分析。结果：在基于病变的分析中，EGFR+ 患者的偏度值较低，具有统计学意义 (p = 0.012)。两组在其他 ADC 直方图分析参数、死亡率和总生存率方面没有显着差异（p > 0.05）。在ROC分析中，区分EGFR突变差异的最合适的偏度截断值确定为0.321，该值具有统计学意义（敏感性：66.7%，特异性：80.6%，AUC：0.730）（p = 0.006） 。结论：本研究的结果为了解根据肺腺癌脑转移中 EGFR 突变状态进行 ADC 直方图分析的差异提供了有价值的见解。确定的参数，尤其是偏度，是预测突变状态的潜在非侵入性生物标志物。将这些生物标志物纳入常规临床实践可能有助于患者的治疗决策和预后评估。需要进一步的验证研究和前瞻性调查来确认这些发现的临床效用，并确定其个性化治疗策略和患者结果的潜力。