Peritumoral and intratumoral magnetic resonance imaging-based radiomics of brain metastases for predicting the response to EGFR-tyrosine kinase inhibitors in metastatic non-small cell lung cancer.

Background: The early prediction of treatment response for EGFR-tyrosine kinase inhibitors (EGFR-TKIs) is critical to guiding therapy in patients with metastatic non-small cell lung cancer (NSCLC). This study aimed to develop a magnetic resonance imaging (MRI)-based radiomics model based on intratumoral and peritumoral regions to assess the response of patients with metastatic NSCLC to EGFR-TKIs. Methods: We retrospectively recruited 418 and 160 patients with brain metastases (BMs) from Results: The combined intratumoral and peritumoral 6-mm regions achieved the best performance, with AUCs of 0.913 and 0.826 in the training and test cohort. The ROI_I model also demonstrated a degree of classification power in both the training and test cohort, with AUCs of 0.868 and 0.762, respectively. Conclusions: As compared to models consisting of intratumoral or peritumoral radiomics features alone, the model combining intratumoral and peritumoral radiomics features achieved better performance in predicting therapeutic response to EGFR-TKIs. The optimal combined region model with 6-mm peritumoral expansion along the tumor may benefit the clinical treatment of NSCLC.