{"title":"肺癌 PET/CT 中 PD-L1 表达与 [18F]FAPI 和 [18F]FDG 摄取之间的关系","authors":"Jingjie Qin, Chao Han, Haoqian Li, Zhendan Wang, Xudong Hu, Lanping Liu, Shouhui Zhu, Jingjing Zhao, Yuhong Sun, Yuchun Wei","doi":"10.1007/s00259-025-07201-6","DOIUrl":null,"url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>To investigate the correlation between [<sup>18</sup>F] labeled fibroblast activation protein inhibitor (FAPI) positron emission tomography (PET)/computed tomography (CT) uptake and programmed death ligand 1 (PD-L1) expression in lung cancer and evaluate the predictive value of [<sup>18</sup>F]FAPI PET/CT for PD-L1 expression compared with [<sup>18</sup>F]fluorodeoxyglucose ([<sup>18</sup>F]FDG) PET/CT.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>This single-center retrospective study consecutively enrolled patients with pathologically confirmed lung cancer who underwent [<sup>18</sup>F]FAPI and [<sup>18</sup>F]FDG PET/CT scans within 2 weeks, with a minimum interval of 20 h. PD-L1 expression was assessed using immunohistochemistry and stratified into three groups. PET/CT uptake parameters included the maximum standard uptake value (SUV<sub>max</sub>) in the biopsy tumor or mediastinal metastasis lymph nodes area and the mean SUV<sub>s</sub> (SUV<sub>mean</sub>) of normal tissue (lung and blood). The ratios of SUV<sub>max</sub> to the SUV<sub>mean</sub> for each normal tissue were denoted as the tumor-to-background ratios (TBR<sub>lung</sub> and TBR<sub>blood</sub>). All statistical analyses were conducted using IBM SPSS Statistics. Normality was assessed, and for non-normally distributed data, the Kruskal-Wallis and Mann-Whitney U tests were applied. Associations between variables were evaluated using Spearman’s rank correlation. All tests were two-sided, with a <i>P</i>-value < 0.05 considered statistically significant.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Among the 75 cases included on the final analysis, the TBR<sub>blood</sub> and TBR<sub>lung</sub> derived from [<sup>18</sup>F]FAPI PET/CT were significantly positively correlated with PD-L1 expression (<i>r</i> = 0.32, <i>P</i> < 0.01; <i>r</i> = 0.26, <i>P</i> < 0.05). Additionally, cases with high PD-L1 expression showed significantly higher [<sup>18</sup>F]FAPI uptake values (mean TBR<sub>lung</sub>=36.16; mean TBR<sub>blood</sub>=10.75) compared with those with low PD-L1 expression (mean TBR<sub>lung</sub>=25.10; mean TBR<sub>blood</sub>=8.04). No statistically significant correlation was observed between [<sup>18</sup>F]FDG uptake values and PD-L1 expression level. Receiver operating characteristic analysis identified TBR<sub>blood</sub> on [<sup>18</sup>F]FAPI PET/CT with a cutoff value of 7.76 (area under the curve = 0.68, <i>P</i> < 0.01, sensitivity = 75%, and specificity = 53.49%) as a significant predictor of the level of PD-L1 expression.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>[<sup>18</sup>F]FAPI uptake was positively correlated with PD-L1 expression in lung cancer. The combination of [<sup>18</sup>F]FAPI PET/CT and PD-L1 expression may offer a more comprehensive approach to assessing the response of lung cancer to immunotherapy.</p><h3 data-test=\"abstract-sub-heading\">Trial registration</h3><p>This study was approved by the Clinical Research Ethics Committee of our institution (institutional review board approval no. SDZLEC2021–112–02).</p>","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"37 1","pages":""},"PeriodicalIF":8.6000,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Relationship between PD-L1 expression and [18F]FAPI versus [18F]FDG uptake on PET/CT in lung cancer\",\"authors\":\"Jingjie Qin, Chao Han, Haoqian Li, Zhendan Wang, Xudong Hu, Lanping Liu, Shouhui Zhu, Jingjing Zhao, Yuhong Sun, Yuchun Wei\",\"doi\":\"10.1007/s00259-025-07201-6\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<h3 data-test=\\\"abstract-sub-heading\\\">Purpose</h3><p>To investigate the correlation between [<sup>18</sup>F] labeled fibroblast activation protein inhibitor (FAPI) positron emission tomography (PET)/computed tomography (CT) uptake and programmed death ligand 1 (PD-L1) expression in lung cancer and evaluate the predictive value of [<sup>18</sup>F]FAPI PET/CT for PD-L1 expression compared with [<sup>18</sup>F]fluorodeoxyglucose ([<sup>18</sup>F]FDG) PET/CT.</p><h3 data-test=\\\"abstract-sub-heading\\\">Methods</h3><p>This single-center retrospective study consecutively enrolled patients with pathologically confirmed lung cancer who underwent [<sup>18</sup>F]FAPI and [<sup>18</sup>F]FDG PET/CT scans within 2 weeks, with a minimum interval of 20 h. PD-L1 expression was assessed using immunohistochemistry and stratified into three groups. PET/CT uptake parameters included the maximum standard uptake value (SUV<sub>max</sub>) in the biopsy tumor or mediastinal metastasis lymph nodes area and the mean SUV<sub>s</sub> (SUV<sub>mean</sub>) of normal tissue (lung and blood). The ratios of SUV<sub>max</sub> to the SUV<sub>mean</sub> for each normal tissue were denoted as the tumor-to-background ratios (TBR<sub>lung</sub> and TBR<sub>blood</sub>). All statistical analyses were conducted using IBM SPSS Statistics. Normality was assessed, and for non-normally distributed data, the Kruskal-Wallis and Mann-Whitney U tests were applied. Associations between variables were evaluated using Spearman’s rank correlation. All tests were two-sided, with a <i>P</i>-value < 0.05 considered statistically significant.</p><h3 data-test=\\\"abstract-sub-heading\\\">Results</h3><p>Among the 75 cases included on the final analysis, the TBR<sub>blood</sub> and TBR<sub>lung</sub> derived from [<sup>18</sup>F]FAPI PET/CT were significantly positively correlated with PD-L1 expression (<i>r</i> = 0.32, <i>P</i> < 0.01; <i>r</i> = 0.26, <i>P</i> < 0.05). Additionally, cases with high PD-L1 expression showed significantly higher [<sup>18</sup>F]FAPI uptake values (mean TBR<sub>lung</sub>=36.16; mean TBR<sub>blood</sub>=10.75) compared with those with low PD-L1 expression (mean TBR<sub>lung</sub>=25.10; mean TBR<sub>blood</sub>=8.04). No statistically significant correlation was observed between [<sup>18</sup>F]FDG uptake values and PD-L1 expression level. Receiver operating characteristic analysis identified TBR<sub>blood</sub> on [<sup>18</sup>F]FAPI PET/CT with a cutoff value of 7.76 (area under the curve = 0.68, <i>P</i> < 0.01, sensitivity = 75%, and specificity = 53.49%) as a significant predictor of the level of PD-L1 expression.</p><h3 data-test=\\\"abstract-sub-heading\\\">Conclusion</h3><p>[<sup>18</sup>F]FAPI uptake was positively correlated with PD-L1 expression in lung cancer. The combination of [<sup>18</sup>F]FAPI PET/CT and PD-L1 expression may offer a more comprehensive approach to assessing the response of lung cancer to immunotherapy.</p><h3 data-test=\\\"abstract-sub-heading\\\">Trial registration</h3><p>This study was approved by the Clinical Research Ethics Committee of our institution (institutional review board approval no. SDZLEC2021–112–02).</p>\",\"PeriodicalId\":11909,\"journal\":{\"name\":\"European Journal of Nuclear Medicine and Molecular Imaging\",\"volume\":\"37 1\",\"pages\":\"\"},\"PeriodicalIF\":8.6000,\"publicationDate\":\"2025-03-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Journal of Nuclear Medicine and Molecular Imaging\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00259-025-07201-6\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Nuclear Medicine and Molecular Imaging","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00259-025-07201-6","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
Relationship between PD-L1 expression and [18F]FAPI versus [18F]FDG uptake on PET/CT in lung cancer
Purpose
To investigate the correlation between [18F] labeled fibroblast activation protein inhibitor (FAPI) positron emission tomography (PET)/computed tomography (CT) uptake and programmed death ligand 1 (PD-L1) expression in lung cancer and evaluate the predictive value of [18F]FAPI PET/CT for PD-L1 expression compared with [18F]fluorodeoxyglucose ([18F]FDG) PET/CT.
Methods
This single-center retrospective study consecutively enrolled patients with pathologically confirmed lung cancer who underwent [18F]FAPI and [18F]FDG PET/CT scans within 2 weeks, with a minimum interval of 20 h. PD-L1 expression was assessed using immunohistochemistry and stratified into three groups. PET/CT uptake parameters included the maximum standard uptake value (SUVmax) in the biopsy tumor or mediastinal metastasis lymph nodes area and the mean SUVs (SUVmean) of normal tissue (lung and blood). The ratios of SUVmax to the SUVmean for each normal tissue were denoted as the tumor-to-background ratios (TBRlung and TBRblood). All statistical analyses were conducted using IBM SPSS Statistics. Normality was assessed, and for non-normally distributed data, the Kruskal-Wallis and Mann-Whitney U tests were applied. Associations between variables were evaluated using Spearman’s rank correlation. All tests were two-sided, with a P-value < 0.05 considered statistically significant.
Results
Among the 75 cases included on the final analysis, the TBRblood and TBRlung derived from [18F]FAPI PET/CT were significantly positively correlated with PD-L1 expression (r = 0.32, P < 0.01; r = 0.26, P < 0.05). Additionally, cases with high PD-L1 expression showed significantly higher [18F]FAPI uptake values (mean TBRlung=36.16; mean TBRblood=10.75) compared with those with low PD-L1 expression (mean TBRlung=25.10; mean TBRblood=8.04). No statistically significant correlation was observed between [18F]FDG uptake values and PD-L1 expression level. Receiver operating characteristic analysis identified TBRblood on [18F]FAPI PET/CT with a cutoff value of 7.76 (area under the curve = 0.68, P < 0.01, sensitivity = 75%, and specificity = 53.49%) as a significant predictor of the level of PD-L1 expression.
Conclusion
[18F]FAPI uptake was positively correlated with PD-L1 expression in lung cancer. The combination of [18F]FAPI PET/CT and PD-L1 expression may offer a more comprehensive approach to assessing the response of lung cancer to immunotherapy.
Trial registration
This study was approved by the Clinical Research Ethics Committee of our institution (institutional review board approval no. SDZLEC2021–112–02).
期刊介绍：
The European Journal of Nuclear Medicine and Molecular Imaging serves as a platform for the exchange of clinical and scientific information within nuclear medicine and related professions. It welcomes international submissions from professionals involved in the functional, metabolic, and molecular investigation of diseases. The journal's coverage spans physics, dosimetry, radiation biology, radiochemistry, and pharmacy, providing high-quality peer review by experts in the field. Known for highly cited and downloaded articles, it ensures global visibility for research work and is part of the EJNMMI journal family.
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