To develop a noninvasive CT-based radiogenomic framework to estimate imaging-associated biomarkers related to natural killer (NK) cell cytotoxicity in clear cell renal cell carcinoma (ccRCC).
Key Findings:
Identified 835 imaging-associated genes enriched in immune-related pathways, particularly NK cell-mediated cytotoxicity.
ICAM1 and RAET1E showed the strongest radiogenomic associations with AUCs of 75.7% and 67.3%, respectively.
Higher ICAM1 and lower RAET1E expression correlated with advanced tumor stage and unfavorable survival outcomes.
External validation achieved predictive accuracies of 76.92% for ICAM1 and 73.08% for RAET1E.
Interpretation:
CT-derived radiomic features may provide noninvasive imaging correlates of biomarkers related to NK cytotoxicity in ccRCC.
Limitations:
Study relies on a single institution's data for initial analysis.
External validation sample size was limited to 26 cases.
Conclusion:
Radiogenomic analysis of ICAM1 and RAET1E may offer a complementary exploratory framework for noninvasive immune characterization and biomarker research in ccRCC.
