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ALK Molecular Phenotype in Non-Small Cell Lung Cancer: CT Radiogenomic Characterization

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dc.contributor.authorYamamoto, Shota-
dc.contributor.authorKorn, Ronald L.-
dc.contributor.authorOklu, Rahmi-
dc.contributor.authorMigdal, Christopher-
dc.contributor.authorGotway, Michael B.-
dc.contributor.authorWeiss, Glen J.-
dc.contributor.authorIafrate, A. John-
dc.contributor.authorKim, Dong-Wan-
dc.contributor.authorKuo, Michael D.-
dc.date.accessioned2020-04-27T11:25:08Z-
dc.date.available2020-04-27T11:25:08Z-
dc.date.issued2014-08-
dc.identifier.citationRadiology, Vol.272 No.2, pp.568-576-
dc.identifier.issn0033-8419-
dc.identifier.other91740-
dc.identifier.urihttp://hdl.handle.net/10371/165414-
dc.description.abstractPurpose: To present a radiogenomic computed tomographic (CT) characterization of anaplastic lymphoma kinase (ALK)-rearranged non-small cell lung cancer (NSCLC) (ALK+). Materials and Methods: In this HIPAA-compliant institutional review board-approved retrospective study, CT studies, ALK status, and clinical-pathologic data in 172 patients with NSCLC from three institutions were analyzed. A screen of 24 CT image traits was performed in a training set of 59 patients, followed by random forest variable selection incorporating 24 CT traits plus six clinical-pathologic covariates to identify a radiogenomic predictor of ALK+ status. This predictor was then validated in an independent cohort (n = 113). Test-for-accuracy and subset analyses were performed. A similar analysis was performed to identify a biomarker associated with shorter progression-free survival (PFS) after therapy with the ALK inhibitor crizotinib. Results: ALK+ status was associated with central tumor location, absence of pleural tail, and large pleural effusion. An ALK+ radiogenomic CT status biomarker consisting of these three imaging traits with patient age of younger than 60 years showed strong discriminatory power for ALK+ status, with a sensitivity of 83.3% (15 of 18), a specificity of 77.9% (74 of 95), and an accuracy of 78.8% (89 of 113) in independent testing. The discriminatory power was particularly strong in patients with operable disease (stage IIIA or lower), with a sensitivity of 100.0% (five of five), a specificity of 88.1% (37 of 42), and an accuracy of 89.4% (42 of 47). Tumors with a disorganized vessel pattern had a shorter PFS with crizotinib therapy than tumors without this trait (11.4 vs 20.2 months, P =.041). Conclusion: ALK+ NSCLC has distinct characteristics at CT imaging that, when combined with clinical covariates, discriminate ALK+ from non-ALK tumors and can potentially identify patients with a shorter durable response to crizotinib.-
dc.titleALK Molecular Phenotype in Non-Small Cell Lung Cancer: CT Radiogenomic Characterization-
dc.typeArticle-
dc.contributor.AlternativeAuthor김동완-
dc.identifier.doi10.1148/radiol.14140789-
dc.citation.journaltitleRadiology-
dc.identifier.scopusid2-s2.0-84904995349-
dc.citation.endpage576-
dc.citation.number2-
dc.citation.startpage568-
dc.citation.volume272-
dc.identifier.urlhttps://pubs.rsna.org/doi/10.1148/radiol.14140789-
dc.identifier.rimsid91740-
dc.identifier.sci000340035100027-
dc.description.isOpenAccessN-
dc.contributor.affiliatedAuthorKim, Dong-Wan-
Appears in Collections:
College of Medicine/School of Medicine (의과대학/대학원)Cancer Research Institute (암연구소)Journal Papers (저널논문_암연구소)
College of Medicine/School of Medicine (의과대학/대학원)Internal Medicine (내과학전공)Journal Papers (저널논문_내과학전공)
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