TY - JOUR
T1 - Quantification of PD-L1 expression with [18F]BMS-986192 PET/CT in patients with advanced stage non-small-cell lung cancer
AU - Huisman, Marc C.
AU - Niemeijer, Anna-Larissa N.
AU - Windhorst, Albert D.
AU - Schuit, Robert C.
AU - Leung, David
AU - Hayes, Wendy
AU - Poot, Alex
AU - Bahce, Idris
AU - Radonic, Teodora
AU - Oprea-Lager, Daniela E.
AU - Hoekstra, Otto S.
AU - Thunnissen, Erik
AU - Hendrikse, N. Harry
AU - Smit, Egbert F.
AU - de Langen, Adrianus J.
AU - Boellaard, Ronald
N1 - Copyright © 2020 by the Society of Nuclear Medicine and Molecular Imaging, Inc.
PY - 2020/10/1
Y1 - 2020/10/1
N2 - The aim of this work was to quantify the uptake of [18F]BMS-986192, a PD-L1 adnectin PET tracer, in patients with non-small-cell lung cancer (NSCLC). To this end, plasma input kinetic modeling of dynamic tumor uptake data with online arterial blood sampling was performed. In addition, the accuracy of simplified uptake metrics such as standardized uptake value (SUV) was investigated. Methods: Data from a study with [18F]BMS-986192 in patients with advanced stage NSCLC eligible for nivolumab treatment were used if a dynamic scan was available and lesions were present in the field of view of the dynamic scan. After injection of [18F]BMS-986192, a 60-minutes dynamic PET-CT scan was started, followed by a 30-min whole body PET-CT scan. Continuous arterial and discrete arterial and venous blood sampling were performed to determine a plasma input function. Tumor time activity curves were fitted by several plasma input kinetic models. Simplified uptake parameters included tumor to blood ratio as well as several SUV measures. Results: Twenty two tumors in nine patients were analyzed. The arterial plasma input single-tissue reversible compartment model with fitted blood volume fraction seems to be the most preferred model as it best fitted 11 out of 18 tumor time activity curves. The distribution volume VT ranged from 0.4 to 4.8 mL·cm-3. Similar values were obtained with an image derived input function. From the simplified measures, SUV normalized for body weight (SUVBW) at 50 and 67 minutes post injection correlated best with VT, with an R2 > 0.9. Conclusion: A single tissue reversible model can be used for the quantification of tumor uptake of the PD-L1 PET tracer [18F]BMS-986192. SUVBW at 60 minutes post injection, normalized for body weight, is an accurate simplified parameter for uptake assessment of baseline studies. In order to assess its predictive value for response evaluation during PD-(L)1 immune checkpoint inhibition further validation of SUV against VT based on an image derived input function is recommended.
AB - The aim of this work was to quantify the uptake of [18F]BMS-986192, a PD-L1 adnectin PET tracer, in patients with non-small-cell lung cancer (NSCLC). To this end, plasma input kinetic modeling of dynamic tumor uptake data with online arterial blood sampling was performed. In addition, the accuracy of simplified uptake metrics such as standardized uptake value (SUV) was investigated. Methods: Data from a study with [18F]BMS-986192 in patients with advanced stage NSCLC eligible for nivolumab treatment were used if a dynamic scan was available and lesions were present in the field of view of the dynamic scan. After injection of [18F]BMS-986192, a 60-minutes dynamic PET-CT scan was started, followed by a 30-min whole body PET-CT scan. Continuous arterial and discrete arterial and venous blood sampling were performed to determine a plasma input function. Tumor time activity curves were fitted by several plasma input kinetic models. Simplified uptake parameters included tumor to blood ratio as well as several SUV measures. Results: Twenty two tumors in nine patients were analyzed. The arterial plasma input single-tissue reversible compartment model with fitted blood volume fraction seems to be the most preferred model as it best fitted 11 out of 18 tumor time activity curves. The distribution volume VT ranged from 0.4 to 4.8 mL·cm-3. Similar values were obtained with an image derived input function. From the simplified measures, SUV normalized for body weight (SUVBW) at 50 and 67 minutes post injection correlated best with VT, with an R2 > 0.9. Conclusion: A single tissue reversible model can be used for the quantification of tumor uptake of the PD-L1 PET tracer [18F]BMS-986192. SUVBW at 60 minutes post injection, normalized for body weight, is an accurate simplified parameter for uptake assessment of baseline studies. In order to assess its predictive value for response evaluation during PD-(L)1 immune checkpoint inhibition further validation of SUV against VT based on an image derived input function is recommended.
KW - PD-L1 expression
KW - PET/CT
KW - immune checkpoint inhibitors
KW - kinetic modeling
UR - http://www.scopus.com/inward/record.url?scp=85091676825&partnerID=8YFLogxK
U2 - https://doi.org/10.2967/jnumed.119.240895
DO - https://doi.org/10.2967/jnumed.119.240895
M3 - Article
C2 - 32060213
SN - 1535-5667
VL - 61
SP - 1455
EP - 1460
JO - Journal of nuclear medicine : official publication, Society of Nuclear Medicine
JF - Journal of nuclear medicine : official publication, Society of Nuclear Medicine
IS - 10
ER -