Comparison of CT radiogenomic and clinical characteristics between EGFR and KRAS mutations in lung adenocarcinomas

•Lung adenocarcinomas with EGFR or KRAS mutations have distinct CT imaging features. •Image type and translucent area were similar in tumours with EGFR or KRAS mutations. •Patients with EGFR or KRAS mutations are more likely to have metastases. Aim To compare computed tomography (CT) radiogenomic and clinical characteristics between patients with epidermal growth factor receptor (EGFR) and Kirsten rat sarcoma viral oncogene (KRAS) mutations in lung adenocarcinomas. Materials and methods This study was a retrospective analysis of patients with histopathologically confirmed lung adenocarcinoma, who had complete clinical and imaging data, and were tested for EGFR and KRAS mutations. Of the 313 included patients, 116 had effective EGFR mutations (EGFR group), 31 had KRAS mutations (KRAS group), and 166 had no EGFR or KRAS mutations (control group). Multivariate analysis was used to evaluate CT imaging features and clinical data. Results Multivariate analysis showed that significant variables between the EGFR and control groups were spiculation (odds ratio [OR] 2.70, 95% confidence interval [CI]: 1.54–4.75, p=0.001), and multiple small metastatic nodules (OR=7.52, 95% CI: 1.44–39.17, p=0.017). Significant variables between the KRAS and the control group were multiple small metastatic nodules (OR=7.65, 95% CI: 1.18–49.50, p=0.033). Conclusions Patients with EGFR or KRAS mutations are prone to multiple metastases in both lungs. In addition, effective EGFR mutations mostly occurred in patients with multiple spiculations. To compare computed tomography (CT) radiogenomic and clinical characteristics between patients with epidermal growth factor receptor (EGFR) and Kirsten rat sarcoma viral oncogene (KRAS) mutations in lung adenocarcinomas. This study was a retrospective analysis of patients with histopathologically confirmed lung adenocarcinoma, who had complete clinical and imaging data, and were tested for EGFR and KRAS mutations. Of the 313 included patients, 116 had effective EGFR mutations (EGFR group), 31 had KRAS mutations (KRAS group), and 166 had no EGFR or KRAS mutations (control group). Multivariate analysis was used to evaluate CT imaging features and clinical data. Multivariate analysis showed that significant variables between the EGFR and control groups were spiculation (odds ratio [OR] 2.70, 95% confidence interval [CI]: 1.54–4.75, p=0.001), and multiple small metastatic nodules (OR=7.52, 95% CI: 1.44–39.17, p=0.017). Significant variables between the KRAS and the control group were multiple small metastatic nodules (OR=7.65, 95% CI: 1.18–49.50, p=0.033). Patients with EGFR or KRAS mutations are prone to multiple metastases in both lungs. In addition, effective EGFR mutations mostly occurred in patients with multiple spiculations.