Araujo-Filho JAB, Chang J, Mayoral M, et al. - Researchers performed this retrospective study to determine if non-small cell lung cancer (NSCLC) patients with separate primary lung carcinomas (SPLCs) vs intrapulmonary metastases (IPMs) display distinct imaging features. For this purpose, they used clonal associations established by comprehensive next-generation sequencing as the ground truth. Patients who had pre-treatment computed tomography (CT) and/or positron emission tomography/CT (PET/CT) imaging followed by surgical resection for > 1 NSCLC were examined. This study included 127 individual tumors from 60 patients; based on NGS profiling, there were 51 SPLC vs 23 IPM tumor pairs among them. SPLCs were identified to be correlated to subsolid consistency and spiculated contours, while IPMs were shown to be correlated to greater difference of size between lesions or pure solid consistency of the smaller lesion. More frequent lymph node involvement was noted in IPMs vs SPLCs. Findings revealed differential distribution of selected preoperative CT characteristics in SPLCs and IPMs, indicating a likely role of imaging in discriminating clonal associations of tumors in patients with > 1 NSCLC.