Abstract: Computed tomography perfusion (CTP) is used in a method to identify cancerous lesions having genetic mutations and treat them accordingly. Also, CTP values are used to distinguish primary versus metastatic lesions. For example, pulmonary blood flow is identified as one biomarker for EGFR and KRAS genetic mutations in lung cancer, lesion having dual-input pulmonary blood flow exceeding a threshold (e.g., 103 ml/min/100 mL with sensitivity 100% and specificity 62%) are determined as having mutations. The CTP values are calculated using a lesion region-of-interest (ROI) placed to include the area of maximum perfusion intensity within the lesion base and surrounding blush, while avoiding regions of perfusion inhomogeneity (e.g., due to necrosis). In certain implementations, instead of a binary determination, the method can generate probabilities associated with respective alternatives (e.g.

Abstract: Computed tomography perfusion (CTP) is used in a method to identify cancerous lesions having genetic mutations and treat them accordingly. Also, CTP values are used to distinguish primary versus metastatic lesions. For example, pulmonary blood flow is identified as one biomarker for EGFR and KRAS genetic mutations in lung cancer, lesion having dual-input pulmonary blood flow exceeding a threshold (e.g., 103 ml/min/100 mL with sensitivity 100% and specificity 62%) are determined as having mutations. The CTP values are calculated using a lesion region-of-interest (ROI) placed to include the area of maximum perfusion intensity within the lesion bass and surrounding blush, while avoiding regions of perfusion inhomogeneity (e.g., due to necrosis). In certain implementations, instead of a binary determination, the method can generate probabilities associated with respective alternatives (e.g.