A prediction model that uses clinical variables and CT radiomic features showed higher performance compared to a prediction model that uses clinical variables only (c-statistic = 0.646 vs. 0.550, P = 0.0299).<h4>Conclusions</h4>Quantitative CT radiomic features can predict PD-L1 expression in advanced stage lung adenocarcinoma. The gene discussed is CD274; the disease is lung adenocarcinoma.