{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T04:57:43Z","timestamp":1781153863242,"version":"3.54.1"},"reference-count":22,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100007289","name":"Nanjing Medical University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007289","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Magnetic Resonance Imaging"],"published-print":{"date-parts":[[2026,7]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n 10%\u201330% of patients with lung adenocarcinoma (LUAD) and leptomeningeal metastasis (LM) respond poorly to conventional and targeted therapy. The relationship between genetic subtypes and both MRI features and survival outcomes remains poorly understood in this patient population.<\/jats:p>\n <\/jats:sec>\n \n Purpose<\/jats:title>\n To explore the genetic phenotypes among LUAD\u2010LM patients who respond poorly to conventional and targeted therapy, and to compare the MRI characteristics and survival outcomes among these genetic phenotypes:<\/jats:p>\n <\/jats:sec>\n \n Study Type<\/jats:title>\n Retrospective.<\/jats:p>\n <\/jats:sec>\n \n Population<\/jats:title>\n 110 LUAD\u2010LM patients (LU confirmed by histology, LM by cytology) treated with intrathecal chemotherapy, comprising 43 with epidermal growth factor receptor exon 21 L858R mutations (EGFR 21), 29 with EGFR exon 19 deletions (EGFR 19), and 38 with Non\u2010Classic and Other Mutations (NCOM).<\/jats:p>\n <\/jats:sec>\n \n Field Strength\/Sequence<\/jats:title>\n \n 3.0T; axial\n T<\/jats:italic>\n 1<\/jats:sub>\n \u2010 and\n T<\/jats:italic>\n 2<\/jats:sub>\n \u2010weighted turbo spin echo (TSE), fluid\u2010attenuated inversion recovery (FLAIR), diffusion\u2010weighted echo\u2010planar imaging (DWI), and post\u2010contrast 3D\n T<\/jats:italic>\n 1<\/jats:sub>\n \u2010weighted gradient\u2010echo sequences (3D T1WI).\n <\/jats:p>\n <\/jats:sec>\n \n Assessment<\/jats:title>\n MRI morphologic features (including LM presence, presentation subtype, and lesion distribution) were independently reviewed by three radiologists (Y. J., W. S., and M. Y., with 5, 5, and 15\u2009years of experience, respectively), following standardized criteria. Intracranial progression\u2010free survival (iPFS) and overall survival (OS) were analyzed from the date of LM diagnosis based on clinical follow\u2010up.<\/jats:p>\n <\/jats:sec>\n \n Statistical Tests<\/jats:title>\n \n Chi\u2010square or Fisher's exact tests for imaging features; Kaplan\u2013Meier method with log\u2010rank tests for survival analysis; Cox proportional hazards regression for multivariable analysis. A two\u2010sided\n p<\/jats:italic>\n \u2009<\u20090.05 was considered significant.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n MRI<\/jats:styled-content>\n \u2010negative\n LM<\/jats:styled-content>\n was significantly more frequent in\n EGFR<\/jats:styled-content>\n 19 (65.5%). However, these patients showed no survival advantage (\n iPFS<\/jats:styled-content>\n :\n p<\/jats:italic>\n \u2009=\u20090.10,\n OS<\/jats:styled-content>\n :\n p<\/jats:italic>\n \u2009=\u20090.64) over other groups. Among\n MRI<\/jats:styled-content>\n \u2010positive\n LM<\/jats:styled-content>\n patients,\n EGFR<\/jats:styled-content>\n 21 affected significantly fewer lobes (<\u20094 lobes: 85.7%) compared to\n NCOM<\/jats:styled-content>\n (<\u20094 lobes: 45.5%). Median\n iPFS<\/jats:styled-content>\n in\n EGFR<\/jats:styled-content>\n 21 was significantly longer than in\n NCOM<\/jats:styled-content>\n (12.0 vs. 6.5\u2009months; 95%\n CI<\/jats:styled-content>\n : 5.16\u20137.84), and\n OS<\/jats:styled-content>\n was also significantly longer (18.0 vs. 10.2\u2009months; 95%\n CI<\/jats:styled-content>\n : 4.79\u201315.61)\n <\/jats:p>\n <\/jats:sec>\n \n Data Conclusion<\/jats:title>\n This radiogenomics study showed that EGFR mutation subtypes are associated with MRI features and survival outcomes in LUAD\u2010LM patients with poor response to conventional and targeted therapies.<\/jats:p>\n <\/jats:sec>\n \n Evidence Level<\/jats:title>\n 3<\/jats:p>\n <\/jats:sec>\n \n Technical Efficacy Stage<\/jats:title>\n 4<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/jmri.70280","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T11:42:28Z","timestamp":1772970148000},"page":"239-248","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Radiogenomics in Leptomeningeal Metastasis of Lung Adenocarcinoma:\n MRI<\/scp>\n Patterns and Survival Outcomes Following Ommaya Reservoir Chemotherapy"],"prefix":"10.1002","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-3467-8068","authenticated-orcid":false,"given":"Yi\u2010zhen","family":"Jia","sequence":"first","affiliation":[{"name":"Department of Radiology The First Affiliated Hospital of Nanjing Medical University Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Radiology The First Affiliated Hospital of Nanjing Medical University Nanjing 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