Computed tomography‐based radiomics and clinical‐genetic features for brain metastasis prediction in patients with stage III/IV epidermal growth factor receptor‐mutant non‐small‐cell lung cancer

Abstract Purpose To evaluate the value of computed tomography (CT)‐based radiomics combined with clinical‐genetic features in predicting brain metastasis in patients with stage III/IV epidermal growth factor receptor (EGFR)‐mutant non‐small‐cell lung cancer (NSCLC). Methods The study included 147 eligible patients treated at our institution between January 2018 and May 2021. Patients were randomly divided into two cohorts for model training (n = 102) and validation (n = 45). Radiomics features were extracted from the chest CT images before treatment, and a radiomics signature was constructed using the Least Absolute Shrinkage and Selection Operator regression. Kaplan–Meier survival analysis was used to describe the differences in brain metastasis‐free survival (BM‐FS) risk. A clinical‐genetic model was developed using Cox regression analysis. Radiomics, genetic, and combined prediction models were constructed, and their predictive performances were evaluated by the concordance index (C‐index). Results Patients with a low radiomics score had significantly longer BM‐FS than those with a high radiomics score in both the training (p