CT radiomics model RaFiST noninvasively stratifies tumor fibrosis and predicts survival in NSCLC

A CT-based radiomics model (RaFiST) predicted tumor fibrosis in NSCLC (AUC 0.879 training, 0.813 test) and identified patients with worse survival (all p<0.01). Combined Clinical-RaFiST model achieved 5-year DFS AUC 0.827.

• On multivariable Cox regression, fibrosis score was an independent risk factor for disease-free survival and overall survival.
• Transcriptomic analysis linked high RaFiST to extracellular matrix remodeling, hypoxia, and immune suppression pathways.

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