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PD-L1 and glucose transporter 1 expression are closely associated, and studies demonstrate correlation of PD-L1 with glucose metabolism.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Aim<\/jats:title>\n                <jats:p>The aim of this study was to investigate the association of fluorine-18 fluorodeoxyglucose positron emission tomography\/computed tomography ([<jats:sup>18<\/jats:sup>F]FDG-PET\/CT) metabolic parameters with PD-L1 expression in primary lung tumour and lymph node metastases in resected NSCLC.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We conducted a retrospective analysis of 210 patients with node-positive resectable stage IIB\u2013IIIB NSCLC. PD-L1 tumour proportion score (TPS) was determined using the DAKO 22C3 immunohistochemical assay. Semi-automated techniques were used to analyse pre-operative [<jats:sup>18<\/jats:sup>F]FDG-PET\/CT images to determine primary and nodal metabolic parameter scores (including max, mean, peak and peak adjusted for lean body mass standardised uptake values (SUV), metabolic tumour volume (MTV), total lesional glycolysis (TLG) and SUV heterogeneity index (HISUV)).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Patients were predominantly male (57%), median age 70 years with non-squamous NSCLC (68%). A majority had negative primary tumour PD-L1 (TPS &lt; 1%; 53%). Mean SUV<jats:sub>max<\/jats:sub>, SUV<jats:sub>mean<\/jats:sub>, SUV<jats:sub>peak<\/jats:sub> and SUL<jats:sub>peak<\/jats:sub> values were significantly higher (<jats:italic>p<\/jats:italic> &lt; 0.05) in those with TPS \u2265 1% in primary tumour (<jats:italic>n<\/jats:italic> = 210) or lymph nodes (<jats:italic>n<\/jats:italic> = 91). However, ROC analysis demonstrated only moderate separability at the 1% PD-L1 TPS threshold (AUCs 0.58\u20130.73). There was no association of MTV, TLG and HISUV with PD-L1 TPS.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>This study demonstrated the association of SUV-based [<jats:sup>18<\/jats:sup>F]FDG-PET\/CT metabolic parameters with PD-L1 expression in primary tumour or lymph node metastasis in resectable NSCLC, but with poor sensitivity and specificity for predicting PD-L1 positivity \u2265 1%.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Clinical relevance statement<\/jats:title>\n                <jats:p>Whilst SUV-based fluorine-18 fluorodeoxyglucose positron emission tomography\/computed tomography metabolic parameters may not predict programmed death-ligand 1 positivity \u2265 1% in the primary tumour and lymph nodes of resectable non-small cell lung cancer independently, there is a clear association which warrants further investigation in prospective studies.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Trial registration<\/jats:title>\n                <jats:p>Non-applicable<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Key Points<\/jats:title>\n                <jats:p>\u2022 <jats:italic>Programmed death-ligand 1 immunohistochemistry has a predictive role in non-small cell lung cancer immunotherapy; however, it is both heterogenous and dynamic.<\/jats:italic><\/jats:p>\n                <jats:p>\u2022 <jats:italic>SUV-based fluorine-18 fluorodeoxyglucose positron emission tomography\/computed tomography ([<\/jats:italic><jats:sup><jats:italic>18<\/jats:italic><\/jats:sup><jats:italic>F]FDG-PET\/CT) metabolic parameters were significantly higher in primary tumour or lymph node metastases with positive programmed death-ligand 1 expression.<\/jats:italic><\/jats:p>\n                <jats:p>\u2022 <jats:italic>These SUV-based parameters could potentially play an additive role along with other multi-modal biomarkers in selecting patients within a predictive nomogram.<\/jats:italic><\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00330-024-10651-5","type":"journal-article","created":{"date-parts":[[2024,2,22]],"date-time":"2024-02-22T20:02:20Z","timestamp":1708632140000},"page":"5889-5902","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Predicting programmed death-ligand 1 (PD-L1) expression with fluorine-18 fluorodeoxyglucose ([18F]FDG) positron emission tomography\/computed tomography (PET\/CT) metabolic parameters in resectable non-small cell lung cancer"],"prefix":"10.1007","volume":"34","author":[{"given":"Daniel Johnathan","family":"Hughes","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleni","family":"Josephides","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"O\u2019Shea","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thubeena","family":"Manickavasagar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolyn","family":"Horst","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Hunter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Tani\u00e8re","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daisuke","family":"Nonaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mieke","family":"Van Hemelrijck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Spicer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicky","family":"Goh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Bille","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleni","family":"Karapanagiotou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2641-7632","authenticated-orcid":false,"given":"Gary J. 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EK has received research funding via institute from Merck, Sharp & Dohme (MSD). GJRC has received research support from NanoMab Technology, Theragnostics and Serac Healthcare, and provides consultancy for GE Healthcare, NanoMab Technology, Amgen, Blue Earth Diagnostics and Full-Life Technologies. The remaining authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"One of the authors has significant statistical expertise. No complex statistical methods were necessary for this paper.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Statistics and biometry"}},{"value":"Written informed consent was not required for this study as per the institutional review board.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"The study underwent ethics review and was approved by UK Research Ethics Committee (UK IRAS 228790) and within the previously described Guy\u2019s Cancer Cohort framework (ref: 18\/NW\/0297).","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"No study subjects have been previously reported to the best of the authors\u2019 knowledge.","order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Study subjects or cohort overlap"}},{"value":"\u2022 This is a retrospective observational study performed at one institution involving individual subjects from several referring centres.","order":8,"name":"Ethics","group":{"name":"EthicsHeading","label":"Methodology"}}]}}