Are there imaging characteristics associated with lung adenocarcinomas harboring ALK rearrangements? Journal Article


Authors: Halpenny, D. F.; Riely, G. J.; Hayes, S.; Yu, H.; Zheng, J.; Moskowitz, C. S.; Ginsberg, M. S.
Article Title: Are there imaging characteristics associated with lung adenocarcinomas harboring ALK rearrangements?
Abstract: Introduction: 5% of lung adenocarcinomas harbor rearrangements of the anaplastic lymphoma kinase (ALK) gene. This study compared computed tomography (CT) imaging features in patients with ALK rearrangements and those with EGFR mutations. Material/methods: 30 patients with ALK rearrangements were studied. 97 patients with epidermal growth factor receptor (EGFR) mutations were used as controls. Features assessed included size and location of thoracic lymphadenopathy, and the size, contour, consistency and location of the primary tumor. Results: 127 lung adenocarcinomas were examined. 30 (24%) tumors harbored ALK rearrangements, 97 (76%) tumors harbored EGFR mutations. ALK tumors had larger thoracic lymphadenopathy than the control group (. p=. 0.005). Both readers identified 17 (57%) patients in the ALK group with lymph nodes >1.5. cm. Reader 1 identified 19 (20%) patients in the EGFR group with lymph nodes >1.5. cm, and reader 2 identified 18 (19%) (kappa 0.969). Patients with ALK rearrangements were more likely to have multifocal lymphadenopathy. Reader 1 identified 22 (73%) ALK patients versus 35 (36%) EGFR patients with multifocal thoracic nodal enlargement, while reader 2 identified 20 (67%) ALK patients versus 30 (31%) EGFR patients (kappa 0.953). 92% of ALK positive lesions were solid. Conclusion: ALK positive lung adenocarcinomas are more likely than EGFR mutant lung adenocarcinomas to be associated with larger volume, multifocal thoracic lymphadenopathy. While routine testing for ALK should be standard, the presence of such characteristics in a solid tumor should further prompt testing for ALK rearrangement.
Keywords: adult; clinical article; controlled study; primary tumor; gene mutation; mutation; comparative study; cancer staging; cancer diagnosis; tumor localization; computer assisted tomography; tumor volume; epidermal growth factor receptor; retrospective study; lung adenocarcinoma; radiology; gene rearrangement; pleura effusion; lymphadenopathy; computed tomography; pleura metastasis; anaplastic lymphoma kinase; computed tomography scanner; human; male; female; article; radiogenomics; anaplastic lymphoma kinase rearrangement
Journal Title: Lung Cancer
Volume: 86
Issue: 2
ISSN: 0169-5002
Publisher: Elsevier Ireland Ltd.  
Date Published: 2014-11-01
Start Page: 190
End Page: 194
Language: English
DOI: 10.1016/j.lungcan.2014.09.007
PROVIDER: scopus
PUBMED: 25312988
PMCID: PMC4655968
DOI/URL:
Notes: Export Date: 1 December 2014 -- Source: Scopus
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MSK Authors
  1. Junting Zheng
    200 Zheng
  2. Michelle S Ginsberg
    235 Ginsberg
  3. Helena Alexandra Yu
    284 Yu
  4. Chaya S. Moskowitz
    280 Moskowitz
  5. Gregory J Riely
    601 Riely
  6. Sara Anne Hayes
    33 Hayes