GIMAP and Lipid Metabolism Imaging in Clear Cell Renal Cell Carcinoma: A Negative Radiogenomic Analysis

Radiogenomics and lipid metabolism are complementary aspects in studying clear cell renal cell carcinoma (ccRCC). The GTPase of immunity-associated proteins (GIMAP) gene family, known for its role in lymphocyte survival and immune regulation, has recently been linked to specific radiogenomic features. This study aimed to determine whether GIMAP expression correlates with radiological markers of lipid metabolism, such as tumor and liver attenuation on non-contrast computed tomography (CT) and abdominal fat distribution. Genomic and imaging data from The Cancer Genome Atlas (TCGA) and The Cancer Imaging Archive (TCIA) were analyzed in a cohort of 205 ccRCC patients. Both traditional and AI-assisted statistical methods (Welch’s t-test with FDR-BH correction, equivalence testing, and robust winsorization) showed no signifi-cant differences between GIMAP-positive and GIMAP-negative tumors. Average tumor attenuation was similar (36.6 vs. 34.6 HU, p=0.180), as were total, visceral, and subcutaneous fat areas (all p>0.13), along with liver attenuation measures (all p>0.5). These results suggest no meaningful link between GIMAP expression and CT-based lipid metabolism indicators, supporting the idea that GIMAP mainly reflects immune rather than metabolic aspects of tumor biology. CT lipid markers are unlikely to be reliable indicators of GIMAP expression. Future radiogenomic models should incorporate both immune and metabolic factors to improve patient classification in ccRCC.