Next Generation Radiogenomics Sequencing for Prediction of EGFR and KRAS Mutation Status in NSCLC Patients Using Multimodal Imaging and Machine Learning Approaches

Aim: In the present work, we aimed to evaluate a comprehensive radiomics framework that enabled prediction of EGFR and KRAS mutation status in NSCLC cancer patients based on PET and CT multi-modalities radiomic features and ML algorithms. Methods: Our study involved 211 NSCLC cancer patient with PET and CTD images. More than twenty thousand radiomic features from different image-feature sets were extracted Feature value was normalized to obtain Z-scores, followed by student t-test students for comparison, high correlated features were eliminated and the False discovery rate (FDR) correction were performed Six feature selection methods and twelve classifiers were used to predict gene status in patient and model evaluation was reported on independent validation sets (68 patients). Results: The best predictive power of conventional PET parameters was achieved by SUVpeak (AUC: 0.69, P-value = 0.0002) and MTV (AUC: 0.55, P-value = 0.0011) for EGFR and KRAS, respectively. Univariate analysis of radiomics features improved prediction power up to AUC: 75 (q-value: 0.003, Short Run Emphasis feature of GLRLM from LOG preprocessed image of PET with sigma value 1.5) and AUC: 0.71 (q-value 0.00005, The Large Dependence Low Gray Level Emphasis from GLDM in LOG preprocessed image of CTD sigma value 5) for EGFR and KRAS, respectively. Furthermore, the machine learning algorithm improved the perdition power up to AUC: 0.82 for EGFR (LOG preprocessed of PET image set with sigma 3 with VT feature selector and SGD classifier) and AUC: 0.83 for KRAS (CT image set with sigma 3.5 with SM feature selector and SGD classifier). Conclusion: We demonstrated that radiomic features extracted from different image-feature sets could be used for EGFR and KRAS mutation status prediction in NSCLC patients, and showed that they have more predictive power than conventional imaging parameters.