en Radiation Biology Radiation Biology مقاله مروری Review article <div style="text-align: justify;"><span style="font-size:10pt"><span style="text-justify:newspaper"><span style="text-kashida-space:50%"><span style="line-height:119%"><span style="font-family:Calibri"><span style="color:black"><span lang="en-US" style="font-size:9.0pt"><span style="font-family:Calibri"><span style="color:#1f497d"><span style="font-style:italic"><span style="font-weight:bold"><span style="language:en-US">Background:</span></span></span></span></span></span> <span lang="en-US" style="font-size:9.0pt"><span style="font-family:Calibri"><span style="language:en-US">Ground-glass nodules (GGNs) represent early-stage lung adenocarcinoma (LUAD) and exhibit substantial genomic and radiomic heterogeneity. Integrating computed tomography (CT) radiomic features with genomic and epigenomic alterations may improve prediction of nodule progression and radiotherapy response. </span></span></span><span lang="en-US" style="font-size:9.0pt"><span style="font-family:Calibri"><span style="color:#1f497d"><span style="font-style:italic"><span style="font-weight:bold"><span style="language:en-US">Materials and Methods: </span></span></span></span></span></span><span lang="en-US" style="font-size:9.0pt"><span style="font-family:Calibri"><span style="language:en-US">A systematic literature search was conducted across PubMed, Scopus, and Web of Science (2010&ndash;2024) using predefined terms related to GGNs, radiogenomics, LUAD, CT radiomics, and radiosensitivity. Studies were included if they reported (1) human GGN data, (2) genomic or epigenomic characterization, and (3) radiomic features or CT phenotypes. Two reviewers independently screened articles, extracted data, and validated radiogenomic associations. </span></span></span><span lang="en-US" style="font-size:9.0pt"><span style="font-family:Calibri"><span style="color:#1f497d"><span style="font-style:italic"><span style="font-weight:bold"><span style="language:en-US">Results: </span></span></span></span></span></span><span lang="en-US" style="font-size:9.0pt"><span style="font-family:Calibri"><span style="language:en-US">A total of 4,820 patients from eligible studies were analyzed. Distinct CT radiomic features - including attenuation, solidity ratio, textural entropy, vascular convergence, and shape irregularity - corresponded with recurrent genomic drivers. EGFR-mutant GGNs typically presented as pure or mixed GGNs with smooth margins, whereas KRAS-, TP53-, and KEAP1/NRF2-altered lesions showed higher solidity and increased heterogeneity. Radiomic complexity correlated with mutational burden, copy-number alterations, and pathway dysregulation in PI3K/AKT/mTOR, MAPK, Hippo/YAP, and TGF-</span></span></span><span lang="el" style="font-size:9.0pt"><span style="font-family:Calibri"><span style="language:el">&beta; </span></span></span><span lang="en-US" style="font-size:9.0pt"><span style="font-family:Calibri"><span style="language:en-US">signaling. Several radiogenomic signatures also corresponded to predicted radiosensitivity or radioresistance, particularly features associated with oxidative stress pathways and immune microenvironment states. </span></span></span><span lang="en-US" style="font-size:9.0pt"><span style="font-family:Calibri"><span style="color:#1f497d"><span style="font-style:italic"><span style="font-weight:bold"><span style="language:en-US">Conclusion: </span></span></span></span></span></span><span lang="en-US" style="font-size:9.0pt"><span style="font-family:Calibri"><span style="language:en-US">Radiogenomic integration provides critical insight into the biological heterogeneity of GGN-associated LUAD. CT radiomic features reflect underlying genomic alterations and may predict progression and radiotherapy responsiveness. This review establishes a structured framework for the radiogenomic interpretation of GGNs and outlines future applications in precision oncology and radiotherapy planning.</span></span></span></span></span></span></span></span></span></div> Ground-glass nodule, lung adenocarcinoma, radiogenomics, X-ray computed tomography, radiotherapy. 875 883 http://ijrr.com/browse.php?a_code=A-10-1-1588&slc_lang=en&sid=1 F. Yao 7900319475328460034469 7900319475328460034469 No Yan’an Hospital Affiliated to Kunming Medical University, Yunnan Kunming 650051, China Y. Wang 7900319475328460034470 7900319475328460034470 No Yan’an Hospital Affiliated to Kunming Medical University, Yunnan Kunming 650051, China Z. Li 7900319475328460034471 7900319475328460034471 No Yan’an Hospital Affiliated to Kunming Medical University, Yunnan Kunming 650051, China D. Li lidb88@163.com 7900319475328460034472 7900319475328460034472 Yes Yan’an Hospital Affiliated to Kunming Medical University, Yunnan Kunming 650051, China