{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T06:18:48Z","timestamp":1783491528373,"version":"3.55.0"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nucl. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      To investigate the correlation between baseline\n                      <jats:sup>1<\/jats:sup>\n                      \u2078F-FDG PET\/CT metabolic parameters and progression-free survival (PFS) in EGFR-mutant lung adenocarcinoma receiving EGFR-TKI treatment, with subgroup analysis for exon 19 deletion (19del) and L858R mutations.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This single-center retrospective study included 175 patients with pathologically confirmed EGFR-mutant lung adenocarcinoma who underwent baseline\n                      <jats:sup>1<\/jats:sup>\n                      \u2078F-FDG PET\/CT prior to EGFR-TKI therapy between 2020 and 2023. Quantitative metabolic parameters, including SUVmax, SUVpeak, metabolic tumor volume (MTV), and total lesion glycolysis (TLG), were measured. Progression-free survival was the primary endpoint. Survival analyses were performed using Kaplan\u2013Meier estimates, log-rank tests, and Cox proportional hazards regression models, with prespecified subgroup analyses according to EGFR mutation subtype (19del vs. L858R).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The median follow-up duration was 48 months. In univariate analysis, higher SUVmax, SUVpeak, MTV, and TLG were significantly associated with shorter PFS (all\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u2009.05), while MTV and TLG failed to reach statistical significanceOn multivariate Cox regression analysis, SUVmax remained independently associated with PFS [hazard ratio (HR)\u2009=\u20091.031, 95% confidence interval 1.001\u20131.059,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.045]. Patients with EGFR 19del mutations demonstrated a significantly longer median PFS compared with those harboring L858R mutations (13.57 vs. 10.37 months,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.02). Third-generation EGFR-TKIs were associated with a significant prolongation of PFS in the 19del subgroup (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u2009.05), whereas no significant benefit was observed in the L858R subgroup, these subgroup findings should be interpreted cautiously as preliminary exploratory observations limited by small sample sizes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Baseline\n                      <jats:sup>1<\/jats:sup>\n                      \u2078F-FDG PET\/CT metabolic parameters, especially SUVmax, are independent prognostic biomarkers for PFS in EGFR-mutant lung adenocarcinoma patients receiving EGFR-TKIs therapy. The prognostic implications of metabolic imaging differ according to EGFR mutation subtype, and further large prospective cohorts are needed to validate our exploratory subgroup findings supporting an integrated approach combining metabolic imaging and molecular stratification for individualized risk assessment.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnume.2026.1864776","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T05:57:36Z","timestamp":1783490256000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Prognostic value of baseline 18F-FDG PET\/CT metabolic parameters in EGFR-mutant lung adenocarcinoma patients treated with EGFR-TKIs"],"prefix":"10.3389","volume":"6","author":[{"given":"Lei","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Nuclear Medicine, Jilin Cancer Hospital","place":["Changchun, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenpeng","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Liaoyuan Central Hospital","place":["Liaoyuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Jilin Cancer Hospital","place":["Changchun, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,8]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"621","DOI":"10.1097\/RLU.0000000000003714","article-title":"Prognostic value of 18F-FDG PET\/CT metabolic parameters in surgically treated stage i lung adenocarcinoma patients","volume":"46","author":"Tosi","year":"2021","journal-title":"Clin Nucl Med"},{"key":"B2","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1055\/a-2777-2278","article-title":"Impact assessment of [18F]FDG PET\/CT in predicting EGFR gene mutation status in patients with lung adenocarcinoma using recovery coefficient-based correction of semi-quantitative and volume-based PET metrics","volume":"65","author":"Leontev","year":"2026","journal-title":"Nuklearmedizin"},{"key":"B3","doi-asserted-by":"publisher","first-page":"32","DOI":"10.5578\/tt.2026011208","article-title":"Association between metabolic activity and molecular alterations in lung adenocarcinoma: insights from 18F-FDG PET\/CT","volume":"74","author":"Yi\u011fit","year":"2026","journal-title":"Tuberk Toraks"},{"key":"B4","doi-asserted-by":"publisher","first-page":"9621","DOI":"10.2147\/CMAR.S216721","article-title":"Poor prognosis with coexistence of EGFR T790M mutation and common EGFR -activating mutation in non- small cell lung cancer","volume":"11","author":"Gao","year":"2019","journal-title":"Cancer Manag Res"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1047","DOI":"10.3390\/jcm9041047","article-title":"Concomitant TP53 mutation confers worse prognosis in EGFR -mutated non-small cell lung cancer patients treated with TKIs","volume":"9","author":"Canale","year":"2020","journal-title":"J Clin Med"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.4274\/tjh.galenos.2026.76768","article-title":"Role of 18 F-FDG PET\/CT metabolic parameters in treatment response evaluation and prognostic assessment of hodgkin lymphoma: a retrospective analysis","author":"Uysal","year":"2026","journal-title":"Turk J Haematol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1380","DOI":"10.2967\/jnumed.120.254482","article-title":"Prognostic value of bone marrow metabolism on pretreatment 18 f-FDG PET\/CT in patients with metastatic melanoma treated with anti-PD-1 therapy. 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