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Assessing dynamic metabolic heterogeneity in non-small cell lung cancer patients via ultra-high sensitivity total-body [18F]FDG PET/CT imaging: quantitative analysis of [18F]FDG uptake in primary tumors and metastatic lymph nodes.
- Source :
- European Journal of Nuclear Medicine & Molecular Imaging; Nov2022, Vol. 49 Issue 13, p4692-4704, 13p, 1 Color Photograph, 1 Chart, 7 Graphs
- Publication Year :
- 2022
-
Abstract
- Purpose: This study aimed to quantitatively assess [<superscript>18</superscript>F]FDG uptake in primary tumor (PT) and metastatic lymph node (mLN) in newly diagnosed non-small cell lung cancer (NSCLC) using the total-body [<superscript>18</superscript>F]FDG PET/CT and to characterize the dynamic metabolic heterogeneity of NSCLC. Methods: The 60-min dynamic total-body [<superscript>18</superscript>F]FDG PET/CT was performed before treatment. The PTs and mLNs were manually delineated. An unsupervised K-means classification method was used to cluster patients based on the imaging features of PTs. The metabolic features, including Patlak-Ki, Patlak-Intercept, SUV<subscript>mean</subscript>, metabolic tumor volume (MTV), total lesion glycolysis (TLG), and textural features, were extracted from PTs and mLNs. The targeted next-generation sequencing of tumor-associated genes was performed. The expression of Ki67, CD3, CD8, CD34, CD68, and CD163 in PTs was determined by immunohistochemistry. Results: A total of 30 patients with stage IIIA–IV NSCLC were enrolled. Patients were divided into fast dynamic FDG metabolic group (F-DFM) and slow dynamic FDG metabolic group (S-DFM) by the unsupervised K-means classification of PTs. The F-DFM group showed significantly higher Patlak-Ki (P < 0.001) and SUV<subscript>mean</subscript> (P < 0.001) of PTs compared with the S-DFM group, while no significant difference was observed in Patlak-Ki and SUV<subscript>mean</subscript> of mLNs between the two groups. The texture analysis indicated that PTs in the S-DFM group were more heterogeneous in FDG uptake than those in the F-DFM group. Higher T cells (CD3<superscript>+</superscript>/CD8<superscript>+</superscript>) and macrophages (CD68<superscript>+</superscript>/CD163<superscript>+</superscript>) infiltration in the PTs were observed in the F-DFM group. No significant difference was observed in tumor mutational burden between the two groups. Conclusion: The dynamic total-body [<superscript>18</superscript>F]FDG PET/CT stratified NSCLC patients into the F-DFM and S-DFM groups, based on Patlak-Ki and SUV<subscript>mean</subscript> of PTs. PTs in the F-DFM group seemed to be more homogenous in terms of [<superscript>18</superscript>F]FDG uptake than those in the S-DFM group. The higher infiltrations of T cells and macrophages were observed in the F-DFM group, which suggested a potential benefit from immunotherapy. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 16197070
- Volume :
- 49
- Issue :
- 13
- Database :
- Complementary Index
- Journal :
- European Journal of Nuclear Medicine & Molecular Imaging
- Publication Type :
- Academic Journal
- Accession number :
- 159866284
- Full Text :
- https://doi.org/10.1007/s00259-022-05904-8