Vasari-Based Features Nomogram to Predict the Tumor-Infiltrating CD8+ T Cell Levels in Glioblastoma

Abstract

Tumor-infiltrating CD8+T cells play a key role inglioblastoma (GB) development, malignant progression, and recurrence. The aim of the study was to establish nomograms based on the Visually AcceSAble Rembrandt Images (VASARI) features of multiparametric magnetic resonance imaging (MRI) to determine the expression levels of tumor-infiltrating CD8+T cells in patients with GB. Pathological and imaging data of 140 patients with GB confirmed by surgery and pathology were retrospectively analyzed. The levels of tumor-infiltrating CD8+T cells in tumor tissue samples obtained from patients were quantified using immunohistochemical staining. Patients were divided into high and low CD8 expression groups. The MRI images of patients with GBwere analyzed by two radiologists using the VASARI scoring system. A total of 25 MRI-based VASARI imaging features were evaluated by two neuroradiologists. The features with the greatest predictive power for CD8 expression levels were, cystic (OR, 3.063; 95% CI: 1.387, 6.766; P=0.006), hemorrhage (OR, 2.980; 95% CI: 1.172, 7.575; P=0.022), and ependymal extension (OR, 0.257; 95% CI: 0.114 0.581; P=0.001). A logistic regression model based on these three features showed better sample predictive performance (AUC=0.745; 95% CI: 0.665, 0.825; Sensitivity=0.527; Specificity=0.857). The VASARI feature-based nomogram model can showpromise to predict the level of infiltrative CD8 expression in GB tumors non-invasively for earlier tissue diagnosis and more aggressive treatment.