Association between radiomics features of DCE-MRI and CD8(+) and CD4(+) TILs in advanced gastric cancer

Objective: The aim of this investigation was to explore the correlation between the levels of tumor-infiltrating CD8(+) and CD4(+) T cells and the quantitative pharmacokinetic parameters of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in patients with advanced gastric cancer. Methods: We retrospectively analyzed the data of 103 patients with histopathologically confirmed advanced gastric cancer (AGC). Three pharmacokinetic parameters, K(ep), K(trans), and V(e), and their radiomics characteristics were obtained by Omni Kinetics software. Immunohistochemical staining was used to determine CD4(+) and CD8(+) TILs. Statistical analysis was subsequently performed to assess the correlation between radiomics characteristics and CD4(+) and CD8(+) TIL density. Results: All patients included in this study were finally divided into either a CD8(+) TILs low-density group (n = 51) (CD8(+) TILs < 138) or a high-density group (n = 52) (CD8(+) TILs ≥ 138), and a CD4(+) TILs low-density group (n = 51) (CD4(+) TILs < 87) or a high-density group (n = 52) (CD4(+) TILs ≥ 87). ClusterShade and Skewness based on K(ep) and Skewness based on K(trans) both showed moderate negative correlation with CD8(+) TIL levels (r = 0.630–0.349, p < 0.001), with ClusterShade based on K(ep) having the highest negative correlation (r = −0.630, p < 0.001). Inertia-based K(ep) showed a moderate positive correlation with the CD4(+) TIL level (r = 0.549, p < 0.001), and the Correlation based on K(ep) showed a moderate negative correlation with the CD4(+) TIL level, which also had the highest correlation coefficient (r = −0.616, p < 0.001). The diagnostic efficacy of the above features was assessed by ROC curves. For CD8(+) TILs, ClusterShade of K(ep) had the highest mean area under the curve (AUC) (0.863). For CD4(+) TILs, the Correlation of K(ep) had the highest mean AUC (0.856). Conclusion: The radiomics features of DCE-MRI are associated with the expression of tumor-infiltrating CD8(+) and CD4(+) T cells in AGC, which have the potential to noninvasively evaluate the expression of CD8(+) and CD4(+) TILs in AGC patients.