CT Radiogenomics Provides a Novel Factor for cM0(i+) Risk Stratification in Localized Renal Cell Carcinoma: A Model...

Area of Science:

• Oncology
• Radiology
• Genomics

Background:

• The pre-metastatic cM0(i+) stage, defined by circulating tumor cells (CTCs), is crucial for localized renal cell carcinoma (LRCC) prognosis.
• Current CTC monitoring lacks flexibility, potentially increasing patient burden and missing prognostic insights.

Purpose of the Study:

• To investigate radiomics as a predictor of cM0(i+) risk in LRCC patients.
• To explore radiomics' potential in developing risk-adapted CTC monitoring strategies.

Main Methods:

• CTC-related genes (CRGs) were identified using public datasets (GSE106363, GSE82198, GSE18670, TCGA-KIRC).
• A radiogenomic model was trained on CT imaging (TCIA) to predict CTC risk stratification (CRS).
• The model's ability to stratify CTC burden and cM0(i+) progression risk was evaluated in an institutional cohort using postoperative CTC assessments.

Main Results:

• Three CRGs (CYFIP2, SLC19A1, ENGASE) were identified.
• The radiogenomic model accurately predicted CRS (AUC=0.82) and served as an independent predictor of cM0(i+)-free survival (HR=3.20).
• High-risk patients showed significantly higher CTC counts and increased risk of cM0(i+) progression.

Conclusions:

• Contrast-enhanced CT radiomics offers a novel factor for stratifying cM0(i+) progression risk in LRCC.
• This finding may facilitate the development of risk-adapted CTC monitoring strategies.