Radiomic features of primary tumor by lung cancer stage: analysis in BRAF mutated non-small cell lung cancer

Background: The clinical features and traditional semantic imaging characteristics of BRAF-mutated non small cell lung cancer (NSCLC) have been previously reported. The radiomic features of BRAF-mutated NSCLC and their role in predicting cancer stage, however, have yet to be investigated. This study's goal is to assess the differences in CT radiomic features of primary NSCLC driven by BRAF mutation and stratified by tumor-node-metastasis (TNM) staging. Methods: Our IRB approved study included 62 patients with BRAF mutations (V600 in 27 and non-V600 in 35 patients), who underwent contrast-enhanced chest CT. Tumor stage was determined based on the 8th edition of TNM staging. Two thoracic radiologists assessed the primary tumor imaging features such, including tumor size (maximum and minimum dimensions) and density (Hounsfield units, HU). De identified transverse CT images (DICOM) were processed with 3D slicer (Version 4.7) for manual lesion segmentation and estimation of radiomic features. Descriptive statistics, multivariate logistic regression, and receiver operating characteristics (ROC) were performed. Results: There were significant differences in the radiomic features based on cancer stages I-IV with the most significant differences between stage IV and stage I lesions [AUC 0.94 (95% CI: 0.86-0.99), P<0.04]. There were also significant differences in radiomic features between stage IV and combined stages I-III [40/113 radiomic features; AUC 0.71 (95% CI: 0.59-0.85); P<0.04-0.0001]. None of the clinical (0/6) or imaging (0/3) features were significantly different between stage IV and combined stages I-III. Conclusions: The radiomic features of primary tumor in BRAF driven NSCLC significantly vary with cancer stage, independent of standard imaging and clinical features.