Patlak-Ki derived from ultra-high sensitivity dynamic total body [18F]FDG PET/CT correlates with the response to induction immuno-chemotherapy in locally advanced non-small cell lung cancer patients

Purpose This study aimed to investigate the predictive value of metabolic features in response to induction immuno-chemotherapy in patients with locally advanced non-small cell cancer (LA-NSCLC), using ultra-high sensitivity dynamic total body [ 18 F]FDG PET/CT. Methods The study analyzed LA-NSCLC p...

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Published in:European journal of nuclear medicine and molecular imaging 2023-09, Vol.50 (11), p.3400-3413
Main Authors: Wang, DaQuan, Qiu, Bo, Liu, QianWen, Xia, LiangPing, Liu, SongRan, Zheng, ChaoJie, Liu, Hui, Mo, YiWen, Zhang, Xu, Hu, YingYing, Zheng, ShiYang, Zhou, Yin, Fu, Jia, Chen, NaiBin, Liu, FangJie, Zhou, Rui, Guo, JinYu, Fan, Wei
Format: Article
Language:English
Subjects:
Carcinoma, Non-Small-Cell Lung - diagnostic imaging
Carcinoma, Non-Small-Cell Lung - drug therapy
Carcinoma, Non-Small-Cell Lung - metabolism
Cardiology
CD163 antigen
CD3 antigen
CD34 antigen
CD8 antigen
CD8-Positive T-Lymphocytes - metabolism
CD8-Positive T-Lymphocytes - pathology
CD86 antigen
Chemotherapy
Clustering
Computed tomography
Fluorine isotopes
Fluorodeoxyglucose F18
Gene sequencing
Glycolysis
Humans
Imaging
Immune system
Immunohistochemistry
Induction Chemotherapy
Ki-67 Antigen - metabolism
Lung cancer
Lung Neoplasms - diagnostic imaging
Lung Neoplasms - drug therapy
Lung Neoplasms - metabolism
Lymphocytes
Lymphocytes T
Macrophages
Medicine
Medicine & Public Health
Metabolism
Metastases
Myeloid cells
Next-generation sequencing
Non-small cell lung carcinoma
Nuclear Medicine
Oncology
Original Article
Orthopedics
Patients
Positron emission
Positron emission tomography
Positron Emission Tomography Computed Tomography - methods
Radiology
Small cell lung carcinoma
Tumor Burden
Tumors
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Summary:Purpose This study aimed to investigate the predictive value of metabolic features in response to induction immuno-chemotherapy in patients with locally advanced non-small cell cancer (LA-NSCLC), using ultra-high sensitivity dynamic total body [ 18 F]FDG PET/CT. Methods The study analyzed LA-NSCLC patients who received two cycles of induction immuno-chemotherapy and underwent a 60-min dynamic total body [ 18 F]FDG PET/CT scan before treatment. The primary tumors (PTs) were manually delineated, and their metabolic features, including the Patlak-Ki, Patlak-Intercept, maximum SUV (SUV max ), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were evaluated. The overall response rate (ORR) to induction immuno-chemotherapy was evaluated according to RECIST 1.1 criteria. The Patlak-Ki of PTs was calculated from the 20–60 min frames using the Patlak graphical analysis. The best feature was selected using Laplacian feature importance scores, and an unsupervised K-Means method was applied to cluster patients. ROC curve was used to examine the effect of selected metabolic feature in predicting tumor response to treatment. The targeted next generation sequencing on 1021 genes was conducted. The expressions of CD68, CD86, CD163, CD206, CD33, CD34, Ki67 and VEGFA were assayed through immunohistochemistry. The independent samples t test and the Mann–Whitney U test were applied in the intergroup comparison. Statistical significance was considered at P   2.779 ml/min/100 g) group ( n  = 23) and low FDG Patlak-Ki (L-FDG-Ki, Patlak-Ki ≤ 2.779 ml/min/100 g) group ( n  = 14). The ORR to induction immuno-chemotherapy was 67.6% (25/37) in the whole cohort, with 87% (20/23) in H-FDG-Ki group and 35.7% (5/14) in L-FDG-Ki group ( P  = 0.001). The sensitivity and specificity of Patlak-Ki in predicting the treatment response were 80% and 75%, respectively [AUC = 0.775 (95%CI 0.605–0.945)]. The expression of CD3 + /CD8 + T cells and CD86 + /CD163 + /CD206 + macrophage
ISSN:1619-7070
1619-7089
DOI:10.1007/s00259-023-06298-x