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Relationship between SUVmax on 18F-FDG PET and PD-L1 expression in hepatocellular carcinoma

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

Our study was to investigate the correlation between 18F-FDG uptake in HCC and tumor PD-L1 expression in HCC, and assess the value of 18F-FDG PET/CT imaging for predicting PD-L1 expression in HCC.

Methods

A total of 102 patients with confirmed HCC were included in this retrospective study. The PD-L1 expression and immune cell infiltrating of tumors were determined through immunohistochemistry staining. The SUVmax of HCC lesions were assessed using 18F-FDG PET/CT. The correlation between PD-L1 expression and the clinicopathological were evaluated by the Cox proportional hazards model and the Kaplan-Meier survival analysis.

Results

The SUVmax of HCC primary tumors was higher in patients with poorly differentiated HCC, large tumor size, portal vein tumor thrombus, lymph node and distant metastases, and death. The SUVmax of HCC are correlated with the PD-L1 expression and the number of cytotoxic T cells and M2 macrophage infiltration. PD-L1 expression was significantly correlated with tumor SUVmax, tumor differentiation, tumor size, portal vein tumor thrombosis, and patient survival status and infiltrating M2 macrophages. Further, our results confirmed that SUVmax, portal vein tumor thrombosis, and the number of infiltrating M2 macrophages were closely related to PD-L1 expression and were independent risk factors by multivariate analysis. The combined assessment of SUVmax values and the presence of portal vein tumor thrombosis by 18F-FDG PET/CT imaging can help determine PD-L1 expression in HCC.

Conclusions

FDG uptake in HCC was positively correlated with the PD-L1 expression and the number of cytotoxic T cells and M2 macrophage infiltration. The combined use of SUVmax and portal vein tumor thrombosis by PET/CT imaging assess the PD-L1 expression better in HCC. These findings also provide a basis for clinical studies to assess the immune status of tumors by PET/CT.

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Data availability

The data could be obtained from the corresponding author upon request.

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Funding

This work was supported in part by the National Key Research and Development Program of China (Grant No. 2020YFA0909000 and 2021YFA0910000), the National Natural Science Foundation of China (Grant No. 81571710, 82001878 and 82171972), and the Shanghai Rising-Star Program (Grant No. 20QA1406100).

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Author notes

  1. Xiang Zhou and Yongquan Hu contributed equally to this work.

Authors and Affiliations

  1. Department of Nuclear Medicine, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, China

    Xiang Zhou, Ruohua Chen, Gang Huang & Jianjun Liu

  2. Department of Nuclear Medicine, The First Affiliated Hospital of Bengbu Medical College, Bengbu, 233004, Anhui, China

    Yongquan Hu

  3. Department of Clinical Laboratory Science, The First Affiliated Hospital of Bengbu Medical College, Bengbu, 233004, China

    Hong Sun

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  1. Xiang Zhou
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Correspondence to Jianjun Liu.

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The study involving human participants was in line with principles of the ethics committee in Renji Hospital and the First Affiliated Hospital of Bengbu Medical College, and the Declaration of Helsinki in 2013. Animal-based research was not included in this study.

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Zhou, X., Hu, Y., Sun, H. et al. Relationship between SUVmax on 18F-FDG PET and PD-L1 expression in hepatocellular carcinoma. Eur J Nucl Med Mol Imaging 50, 3107–3115 (2023). https://doi.org/10.1007/s00259-023-06251-y

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