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Usefulness of [18F]fluorodeoxyglucose PET/CT for evaluating the PD-L1 status in nasopharyngeal carcinoma

European Journal of Nuclear Medicine and Molecular Imaging volume 47, pages 1065–1074 (2020)Cite this article

Abstract

Purpose

To explore the relationship between [18F]fluorodeoxyglucose (18F-FDG uptake) and PD-L1 expression and determine the usefulness of 18F-FDG PET/CT for evaluating the PD-L1 status in tumour cells (TCs) and tumour-infiltrating immune cells (TIICs) in patients with nasopharyngeal carcinoma (NPC).

Methods

We retrospectively evaluated the records of 84 eligible patients who received an initial histopathological diagnosis of NPC between December 2016 and March 2019. All tissue specimens and PET/CT images were collected prior to treatment. High PD-L1 expression in TCs and TIICs was defined as ≥ 50% of stained cells.

Results

There was a significant difference in 18F-FDG uptake according to the PD-L1 status in TCs and TIICs. Univariate analysis showed that PD-L1 expression in TCs was associated with tumour maximum standardized uptake value (SUVmax) (P < 0.001), primary tumour total lesion glycolysis (TLG; P < 0.001), and T stage (P = 0.044), but not with plasma Epstein-Barr virus (EBV) load (P = 0.816), whereas PD-L1 expression in TIICs was related to SUVmax (P = 0.011), TLG (P = 0.001), T stage (P = 0.028), and plasma EBV load (P = 0.003). In multivariate logistic regression, PD-L1 expression in TCs was positively associated with SUVmax (P = 0.003) and TLG (P = 0.001), and in TIICs, negatively associated with SUVmax (P = 0.038) and plasma EBV load (P = 0.025).

Conclusions

18F-FDG uptake in NPC lesions was positively correlated with PD-L1 expression in TCs and negatively correlated with PD-L1 expression in TIICs. Thus, 18F-FDG PET/CT may be useful for evaluating the PD-L1 status in patients with NPC.

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Funding

This work was funded by the Natural Science Foundation of Fujian Province (Grant number 2016 J01633) and National Natural Science Foundation of China (Grant numbers 81772893 and 81701736).

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Author notes

  1. Liang Zhao, Yanzhen Zhuang and Kaili Fu contributed equally to this work.

Affiliations

  1. Department of Radiation Oncology, Xiamen Cancer Hospital, The First Affiliated Hospital of Xiamen University, Teaching Hospital of Fujian Medical University, Xiamen, China

    Liang Zhao, Kaili Fu, Jianfang Zhuo, Xiyi Liao & Qin Lin

  2. Department of Pathology, The First Affiliated Hospital of Xiamen University, Teaching Hospital of Fujian Medical University, Xiamen, China

    Yanzhen Zhuang, Peiqiong Chen & Yuhuan Wang

  3. Department of Nuclear Medicine & Minnan PET Center, Xiamen Cancer Hospital, The First Affiliated Hospital of Xiamen University, Teaching Hospital of Fujian Medical University, Xiamen, China

    Haojun Chen

Authors
  1. Liang Zhao
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  2. Yanzhen Zhuang
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  4. Peiqiong Chen
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  9. Qin Lin
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Corresponding authors

Correspondence to Haojun Chen or Qin Lin.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

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Zhao, L., Zhuang, Y., Fu, K. et al. Usefulness of [18F]fluorodeoxyglucose PET/CT for evaluating the PD-L1 status in nasopharyngeal carcinoma. Eur J Nucl Med Mol Imaging 47, 1065–1074 (2020). https://doi.org/10.1007/s00259-019-04654-4

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  • DOI: https://doi.org/10.1007/s00259-019-04654-4

Keywords

  • Nasopharyngeal carcinoma
  • PD-L1
  • PET/CT
  • SUVmax
  • TLG