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Prognostic Value of 18 F-FDG PET/CT Metabolic Parameters in Resectable Non-small Cell Lung Cancer Treated With Neoadjuvant Immunotherapy Plus Chemotherapy

  • 0Department of PET Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China.
Clinical Nuclear Medicine +

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March 20, 2025

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March 20, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

18F-FDG PET/CT metabolic parameters, particularly the change in SUVmax (ΔSUVmax), accurately predict prognosis in non-small cell lung cancer (NSCLC) patients receiving neoadjuvant immunotherapy plus chemotherapy. The PERCIST criteria are superior to iRECIST for assessing treatment response and guiding clinical decisions.

Area Of Science

  • Nuclear Medicine
  • Oncology
  • Radiomics

Background

  • Neoadjuvant immunotherapy plus chemotherapy is a standard treatment for resectable non-small cell lung cancer (NSCLC).
  • Accurate prediction of treatment response and prognosis is crucial for optimizing patient management.
  • 18F-FDG PET/CT metabolic parameters offer quantitative insights into tumor metabolism and response to therapy.

Purpose Of The Study

  • To evaluate the predictive value of 18F-FDG PET/CT metabolic parameters for prognosis in NSCLC patients undergoing neoadjuvant immunotherapy plus chemotherapy.
  • To compare the efficacy of PERCIST and iRECIST criteria in assessing treatment response and predicting outcomes.

Main Methods

  • Retrospective analysis of 131 NSCLC patients treated with neoadjuvant immunotherapy plus chemotherapy.
  • Evaluation of pre- and post-treatment 18F-FDG PET/CT metabolic parameters (SUVmax, SUVmean, SUVpeak, MTV, TLG).
  • Comparison of CT-based iRECIST with PET/CT-based PERCIST; ROC and survival analyses (univariate, Cox multivariate) were performed.

Main Results

  • PERCIST showed high prognostic consistency, outperforming iRECIST (P <0.001).
  • Post-treatment and Δ metabolic parameters (e.g., ΔSUVmax) were significant predictors of prognosis (P <0.05).
  • ΔSUVmax emerged as the most potent independent prognostic factor in multivariate analysis.

Conclusions

  • PERCIST is a more accurate tool than iRECIST for evaluating prognosis in NSCLC patients receiving neoadjuvant chemo-immunotherapy.
  • 18F-FDG PET/CT metabolic parameters, especially ΔSUVmax, effectively predict patient outcomes and aid clinical decision-making.

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