Objective To investigate the feasibility of dual-energy CT (DECT) quantitative parameters for the assessment of EGFR mutations in patients with advanced lung adenocarcinoma.

Methods The clinical data of 80 patients with advanced lung adenocarcinoma confirmed by pathology were retrospectively analyzed, and DECT double-phase enhanced scanning was performed before the pathology results were obtained. DECT quantitative parameters included iodine concentration (IC) in the arteriovenous phases, normalized iodine concentration (NIC), and slope of energy spectrum curve from 40 to 100 keV(k_{40 to 100 keV}). All patients underwent EGFR gene test and were divided into mutant group and wild group according to EGFR gene mutation. Logistic regression mode1 for predicting EGFR gene mutation was constructed based on statistically significant parameters, and the receiver operating characteristic (ROC) curve was used to evaluate the predictive efficacy of the mode1.

Results Among 80 patients, there were 46 patients with EGFR gene mutation, and 34 patients without EGFR gene mutation. Arterialphase IC, arterial phase NIC, arterial phase k_{40 to 100 keV}, and venous phase IC in the mutant group were higher than those in the wild group (P < 0.05). The NIC and k_{40 to 100 keV} in venous phase in the mutant group were higher than those in the wild group, but the differences were not statistically significant(P>0.05). Model 1 was established by combining four DECT parameters. The ROC curve showed that the area under the curve (AUC) was 0.725, the sensitivity was 61.11%, and the specificity was 91.30%. Model 2 was established by combining four DECT parameters and clinical features (gender and smoking status). The ROC curve showed the AUC was 0.749, sensitivity was 61.68%, and specificity was 95.73%.

Conclusion In patients with advanced lung adenocarcinoma, DECT quantitative parameters have certain value in predicting EGFR gene mutation.