Association between CT-detected brain metastases and EGFR mutation status in non–small cell lung cancer

Abstract

Background and aim: To evaluate the relationship between head multidetector computed tomography (MDCT) features of brain metastases and epidermal growth factor receptor (EGFR) mutation status in patients with histologically confirmed non‑small cell lung carcinoma (NSCLC). Methods: In this retrospective cross‑sectional study, medical records and PACS imaging from Dr. Wahidin Sudirohusodo General Hospital (January 2022–May 2025) were screened. Of 1,096 patients with lung tumors, 33 met inclusion criteria (histopathologically confirmed NSCLC, available EGFR result, and evaluable head MDCT demonstrating brain metastasis). Head MDCT scans were reviewed for number of lesions, rim enhancement, peritumoral vasogenic edema, hemorrhagic component, leptomeningeal disease and calcification. Results: Patients were classified as EGFR‑mutant (n = 14) or EGFR‑wild‑type (n = 19). The cohort was 60.6% male, most patients were aged 56–65 years, and 51.5% were never‑smokers. Rim enhancement on MDCT differed by EGFR status: EGFR‑wild‑type lesions more often demonstrated rim enhancement (94.7% of wild‑type vs. 42.9% of mutant lesions), while EGFR‑mutant lesions more often lacked rim enhancement (57.1%); this association was statistically significant (p = 0.002). No significant relationships were found between EGFR status and number of lesions, vasogenic edema, hemorrhagic change, leptomeningeal involvement or calcification (all p > 0.05). NSCLC histologic subtype and EGFR mutation subtype analyses similarly showed no statistically significant associations with the assessed MDCT features. Conclusions: This study showed rim enhancement on head MDCT was associated with EGFR status, being more frequent in EGFR‑wild‑type tumors; other MDCT features were not significantly related to EGFR mutation. Larger, prospective studies using MRI and comprehensive molecular profiling are warranted to validate these observations.

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