Sensitivity and specificity of amide proton transfer-weighted imaging for assessing programmed death-ligand 1 status in non-small cell lung cancer: a comparative study with intravoxel incoherent motion and 18F-FDG PET

Abstract

Background: Noninvasive assessment of programmed death-ligand 1 (PD-L1) expression status in nonsmall cell lung cancer (NSCLC) is necessary. This study arm to investigate the value of 2-[ 18 F]-fluoro-2deoxy-D-glucose positron emission tomography ( 18 F-FDG PET), diffusion-weighted imaging (DWI), intravoxel incoherent motion (IVIM), and amide proton transfer-weighted imaging (APTWI) in the assessment of PD-L1 status in NSCLC.Methods: This is a prospective diagnostic study. A total of 76 patients with NSCLC underwent chest 18 F-FDG PET/magnetic resonance imaging (MRI). Parameters maximum standardized uptake value (SUV max ), quantitate the metabolic tumor volume (MTV), total lesion glycolysis (TLG), apparent diffusion coefficient (ADC), diffusion coefficient (D), pseudo diffusion coefficient (D*), and perfusion fraction (f), and magnetization transfer ratio asymmetry at 3.5 ppm [MTRasym (3.5 ppm)] from 18 F-FDG PET, DWI, IVIM, and APTWI, respectively, were compared. The optimal combination of parameters was investigated using logistic regression models and evaluated by area under the receiver operating characteristic (ROC) curve (AUC). The bootstrap with 1,000 samples was used for model validation.Results: SUV max , MTV, TLG, and MTRasym (3.5 ppm) were higher and D and f were lower in PD-L1 positive NSCLC than in PD-L1 negative NSCLC (all P<0.05). Logistic analysis showed that the combination of MTRasym (3.5 ppm), D, and SUV max had the strongest predictive value for the differentiation of PD-L1 positive and PD-L1 negative NSCLC [AUC, 0.946; 95% confidence interval (CI): 0.869-0.985; sensitivity, 85.29%; specificity, 91.67%; P all <0.001]. The verification model showed the combination of MTRasym (3.5 ppm), D, and SUV max had the strongest predictive value, and its ROC curve and calibration curve showed good accuracy (AUC, 0.919, 95% CI: 0.891-0.937) and consistency.Conclusions: Multi-parametric 18 F-FDG PET/MRI is beneficial for the non-invasive assessment of PD-L1 status in NSCLC patients, and the combination of SUV max , D, and MTRasym (3.5 ppm) may serve as aThe study was conducted in accordance with the Declaration of Helsinki (as revised in 2013). This prospective study was complied with ethical committee standards and approved by the ethics committee of prognostic biomarker to guide immunotherapy.

Amide proton transfer-weighted imaging and stretch-exponential model DWI based 18F-FDG PET/MRI for differentiation of benign and malignant solitary pulmonary lesions

“…Due to the inherent tissue heterogeneity in tumourous lesions, relying on a single parameter for a comprehensive and accurate assessment can be challenging [ 33 ]. Previous studies have highlighted the advantages of using multi-parameter combination diagnosis based on multiple quantitative or semi-quantitative parameters, particularly multiple independent predictors, in improving the diagnosis and evaluation of tumours compared with relying on single parameters [ 34 , 35 ]. Accordingly, the study employed univariate and multivariate LR analysis to identify independent predictors (SUV max , MTRasym [3.5 ppm], and ADC) for differentiating between benign and malignant SPLs among various clinical factors and quantitative and semi-quantitative parameters.…”

Current status and prospect of PET-related imaging radiomics in lung cancer

“…Meng et al. ( 48 ) conducted a prospective collection of 18 F-FDG PET/MRI image data from 76 NSCLC patients to develop a predictive model. Their findings highlighted the value of 18 F-FDG PET/MRI for the non-invasive assessment of PD-L1 status in NSCLC.…”

“…Zhou et al (47) similarly demonstrated the efficacy of 18 F-FDG-PET/CT-based radiological features in predicting TMIT-I in NSCLC, offering a promising approach for immunotherapy selection. Meng et al (48) conducted a prospective collection of 18 F-FDG PET/MRI image data from 76 NSCLC patients to develop a predictive model. Their findings highlighted the value of 18 F-FDG PET/MRI for the non-invasive assessment of PD-L1 status in NSCLC.…”

B1 Power Modification for Amide Proton Transfer Imaging in Parotid Glands: A Strategy for Image Quality Accommodation and Evaluation of Tumor Detection Feasibility

“…APT application for tumor detection and characterization was first explored and is best understood in the brain [ 12 , 13 ]. Until now, more and more APT studies have been reported in breast [ 14 , 15 , 16 ], cervix [ 17 , 18 ], prostate [ 19 , 20 , 21 ], and chest tumors [ 22 , 23 ], demonstrating its feasibility for tumor detection and characterization. However, APT weighted (APTw) imaging studies in head and neck tumors face obstacles considering motion effects such as breathing and swallowing, although the parotid glands are thought to be less influenced by such motion disturbance [ 24 ].…”