CT-Based Radiomics Predicts the Functional State of Tumor-Infiltrating CD8⁺ T Cells and Prognosis in NSCLC

Area of Science:

• Oncology
• Immunology
• Radiology

Background:

• CD8+ T cell functional status is crucial for non-small cell lung cancer (NSCLC) patient prognosis.
• Tumor-infiltrating CD8+ T cells play a significant role in anti-tumor immunity.
• Understanding T cell exhaustion is vital for developing effective cancer therapies.

Purpose of the Study:

• To develop a radiomics model for predicting CD8+ T cell functional exhaustion in NSCLC.
• To identify semantic imaging features associated with T cell exhaustion.
• To create a prognostic nomogram for recurrence-free survival.

Main Methods:

• Retrospective analysis of 256 NSCLC patients with preoperative contrast-enhanced CT scans.
• Radiomic feature extraction and modeling using least absolute shrinkage and selection operator.
• Multiplex immunofluorescence staining for CD8+ T cell functional status determination.
• Development of a nomogram integrating radiomics and clinical data for survival prediction.

Main Results:

• A radiomics model for predicting dysfunctional CD8+ T cells at the invasive margin (high-Tdys) was successfully developed (AUC 0.933 training, 0.792 validation).
• Peritumoral CT features like fibrosis, inflammation, and atelectasis correlated with CD8+ T cell exhaustion.
• The prognostic nomogram showed predictive value for recurrence-free survival in both training and validation sets.

Conclusions:

• Radiomics effectively predicts functional exhaustion of tumor-infiltrating CD8+ T cells in NSCLC.
• Specific CT imaging features are linked to CD8+ T cell exhaustion.
• Integrating radiomics with clinical factors improves prognostic assessment for NSCLC patients.