Elevated FDG uptake in non-tumorous lung regions does not predict immune checkpoint inhibitor–related pneumonitis in lung cancer patients
BackgroundPredictors for checkpoint inhibitor-related pneumonitis (cinrPneumonitis) are desperately needed. This study aimed to investigate the pretreatment standardized uptake value (SUV) on [18F]FDG-PET/CT of non-tumorous lung tissue as a predictive imaging marker for the development of cinrPneumo...
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Frontiers Media S.A.
2025-08-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2025.1563030/full |
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| author | Friederike Völter Friederike Völter Friederike Völter Lukas Wehlte Blerina Resuli Blerina Resuli Blerina Resuli Julia Walter Julia Walter Julia Walter Lea Daisenberger Maria Ingenerf Maurice Heimer Matthias Brendel Matthias Brendel Matthias Brendel Gabriel T. Sheikh Lena M. Unterrainer Lena M. Unterrainer Lena M. Unterrainer Diego Kauffmann-Guerrero Diego Kauffmann-Guerrero Diego Kauffmann-Guerrero Thomas Pfluger Lucie Heinzerling Lucie Heinzerling Amanda Tufman Amanda Tufman Amanda Tufman |
| author_facet | Friederike Völter Friederike Völter Friederike Völter Lukas Wehlte Blerina Resuli Blerina Resuli Blerina Resuli Julia Walter Julia Walter Julia Walter Lea Daisenberger Maria Ingenerf Maurice Heimer Matthias Brendel Matthias Brendel Matthias Brendel Gabriel T. Sheikh Lena M. Unterrainer Lena M. Unterrainer Lena M. Unterrainer Diego Kauffmann-Guerrero Diego Kauffmann-Guerrero Diego Kauffmann-Guerrero Thomas Pfluger Lucie Heinzerling Lucie Heinzerling Amanda Tufman Amanda Tufman Amanda Tufman |
| author_sort | Friederike Völter |
| collection | DOAJ |
| description | BackgroundPredictors for checkpoint inhibitor-related pneumonitis (cinrPneumonitis) are desperately needed. This study aimed to investigate the pretreatment standardized uptake value (SUV) on [18F]FDG-PET/CT of non-tumorous lung tissue as a predictive imaging marker for the development of cinrPneumonitis in 239 patients with lung cancer.MethodsAll patients with lung cancer receiving [18F]Fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) prior to immune checkpoint inhibitor (ICI) therapy were included and retrospectively analyzed. Pretreatment SUVMEAN, SUVMAX, SUV95, SUV normalized by lean body mass (SULMEAN, SULMAX) and clinical variables were compared for patients with and without cinrPneumonitis. Logistic regression analyses were performed to identify the predictive value of pretreatment SUV for the development of cinrPneumonitis.ResultsA total of 239 patients were included, of whom 41 (17.2%) developed cinrPneumonitis. The pretreatment radioligand uptake (SUVMEAN, SUVMAX, SUV95, SULMEAN and SULMAX) was not significantly elevated in patients who developed cinrPneumonitis. Logistic regression using sex, age, body mass index and chronic obstructive pulmonary disease as covariables additionally showed no significant association between pretreatment radioligand uptake and the risk of cinrPneumonitis. However, an increased likelihood of developing cinrPneumonitis (relative risk = 1.979; p = 0.027) was shown in patients who received thoracic radiation during ICI therapy.ConclusionThis is the largest study on the association of pretreatment radioligand uptake of the non-tumorous lung and the risk of a cinrPneumonitis. Our results showed no significant association between elevated pretreatment radioligand uptake of non-tumorous lung tissue on FDG-PET/CT and the development of cinrPneumonitis. |
| format | Article |
| id | doaj-art-dbbae6c8bc6e447eb1dd344cb600e27f |
| institution | Kabale University |
| issn | 2234-943X |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Oncology |
| spelling | doaj-art-dbbae6c8bc6e447eb1dd344cb600e27f2025-08-20T05:32:55ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-08-011510.3389/fonc.2025.15630301563030Elevated FDG uptake in non-tumorous lung regions does not predict immune checkpoint inhibitor–related pneumonitis in lung cancer patientsFriederike Völter0Friederike Völter1Friederike Völter2Lukas Wehlte3Blerina Resuli4Blerina Resuli5Blerina Resuli6Julia Walter7Julia Walter8Julia Walter9Lea Daisenberger10Maria Ingenerf11Maurice Heimer12Matthias Brendel13Matthias Brendel14Matthias Brendel15Gabriel T. Sheikh16Lena M. Unterrainer17Lena M. Unterrainer18Lena M. Unterrainer19Diego Kauffmann-Guerrero20Diego Kauffmann-Guerrero21Diego Kauffmann-Guerrero22Thomas Pfluger23Lucie Heinzerling24Lucie Heinzerling25Amanda Tufman26Amanda Tufman27Amanda Tufman28Department of Nuclear Medicine, LMU University Hospital, Munich, GermanyDepartment of Medicine IV, Endocrinology, Diabetes and Metabolism, LMU University Hospital, Munich, GermanyGerman Center for Lung Research (Deutsches Zentrum für Lungenforschung (DZL)) (Comprehensive Pneumology Center - Munich (CPC-M)), Munich, GermanyDepartment of Medicine V, LMU University Hospital, Munich, GermanyGerman Center for Lung Research (Deutsches Zentrum für Lungenforschung (DZL)) (Comprehensive Pneumology Center - Munich (CPC-M)), Munich, GermanyDepartment of Medicine V, LMU University Hospital, Munich, GermanyBayerisches Zentrum für Krebsforschung (BZKF), Munich, GermanyGerman Center for Lung Research (Deutsches Zentrum für Lungenforschung (DZL)) (Comprehensive Pneumology Center - Munich (CPC-M)), Munich, GermanyDepartment of Medicine V, LMU University Hospital, Munich, GermanyBayerisches Zentrum für Krebsforschung (BZKF), Munich, GermanyDepartment of Dermatology and Allergy, LMU University Hospital, Munich, GermanyDepartment of Radiology, LMU University Hospital, Munich, GermanyDepartment of Radiology, LMU University Hospital, Munich, GermanyDepartment of Nuclear Medicine, LMU University Hospital, Munich, GermanyMunich Cluster for Systems Neurology (SyNergy), Munich, GermanyGerman Center for Neurodegenerative Diseases (DZNE), Munich, GermanyDepartment of Nuclear Medicine, LMU University Hospital, Munich, GermanyDepartment of Nuclear Medicine, LMU University Hospital, Munich, GermanyBayerisches Zentrum für Krebsforschung (BZKF), Munich, Germany0Ahmanson Translational Theranostics Division, Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA, United StatesGerman Center for Lung Research (Deutsches Zentrum für Lungenforschung (DZL)) (Comprehensive Pneumology Center - Munich (CPC-M)), Munich, GermanyDepartment of Medicine V, LMU University Hospital, Munich, GermanyBayerisches Zentrum für Krebsforschung (BZKF), Munich, GermanyDepartment of Nuclear Medicine, LMU University Hospital, Munich, GermanyDepartment of Dermatology and Allergy, LMU University Hospital, Munich, Germany1Department of Dermatology, University Hospital Erlangen, Comprehensive Cancer Center Erlangen – European Metropolitan Region Nürnberg, Comprehensive Cancer Center (CCC) Alliance Würzburg, Erlangen, Regensburg, and Augsburg (WERA), Erlangen, GermanyGerman Center for Lung Research (Deutsches Zentrum für Lungenforschung (DZL)) (Comprehensive Pneumology Center - Munich (CPC-M)), Munich, GermanyDepartment of Medicine V, LMU University Hospital, Munich, GermanyBayerisches Zentrum für Krebsforschung (BZKF), Munich, GermanyBackgroundPredictors for checkpoint inhibitor-related pneumonitis (cinrPneumonitis) are desperately needed. This study aimed to investigate the pretreatment standardized uptake value (SUV) on [18F]FDG-PET/CT of non-tumorous lung tissue as a predictive imaging marker for the development of cinrPneumonitis in 239 patients with lung cancer.MethodsAll patients with lung cancer receiving [18F]Fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) prior to immune checkpoint inhibitor (ICI) therapy were included and retrospectively analyzed. Pretreatment SUVMEAN, SUVMAX, SUV95, SUV normalized by lean body mass (SULMEAN, SULMAX) and clinical variables were compared for patients with and without cinrPneumonitis. Logistic regression analyses were performed to identify the predictive value of pretreatment SUV for the development of cinrPneumonitis.ResultsA total of 239 patients were included, of whom 41 (17.2%) developed cinrPneumonitis. The pretreatment radioligand uptake (SUVMEAN, SUVMAX, SUV95, SULMEAN and SULMAX) was not significantly elevated in patients who developed cinrPneumonitis. Logistic regression using sex, age, body mass index and chronic obstructive pulmonary disease as covariables additionally showed no significant association between pretreatment radioligand uptake and the risk of cinrPneumonitis. However, an increased likelihood of developing cinrPneumonitis (relative risk = 1.979; p = 0.027) was shown in patients who received thoracic radiation during ICI therapy.ConclusionThis is the largest study on the association of pretreatment radioligand uptake of the non-tumorous lung and the risk of a cinrPneumonitis. Our results showed no significant association between elevated pretreatment radioligand uptake of non-tumorous lung tissue on FDG-PET/CT and the development of cinrPneumonitis.https://www.frontiersin.org/articles/10.3389/fonc.2025.1563030/fulllung cancerNSCLCSCLC[18F]FDG-PET/CTstandardized uptake valuecheckpoint inhibitor therapy |
| spellingShingle | Friederike Völter Friederike Völter Friederike Völter Lukas Wehlte Blerina Resuli Blerina Resuli Blerina Resuli Julia Walter Julia Walter Julia Walter Lea Daisenberger Maria Ingenerf Maurice Heimer Matthias Brendel Matthias Brendel Matthias Brendel Gabriel T. Sheikh Lena M. Unterrainer Lena M. Unterrainer Lena M. Unterrainer Diego Kauffmann-Guerrero Diego Kauffmann-Guerrero Diego Kauffmann-Guerrero Thomas Pfluger Lucie Heinzerling Lucie Heinzerling Amanda Tufman Amanda Tufman Amanda Tufman Elevated FDG uptake in non-tumorous lung regions does not predict immune checkpoint inhibitor–related pneumonitis in lung cancer patients Frontiers in Oncology lung cancer NSCLC SCLC [18F]FDG-PET/CT standardized uptake value checkpoint inhibitor therapy |
| title | Elevated FDG uptake in non-tumorous lung regions does not predict immune checkpoint inhibitor–related pneumonitis in lung cancer patients |
| title_full | Elevated FDG uptake in non-tumorous lung regions does not predict immune checkpoint inhibitor–related pneumonitis in lung cancer patients |
| title_fullStr | Elevated FDG uptake in non-tumorous lung regions does not predict immune checkpoint inhibitor–related pneumonitis in lung cancer patients |
| title_full_unstemmed | Elevated FDG uptake in non-tumorous lung regions does not predict immune checkpoint inhibitor–related pneumonitis in lung cancer patients |
| title_short | Elevated FDG uptake in non-tumorous lung regions does not predict immune checkpoint inhibitor–related pneumonitis in lung cancer patients |
| title_sort | elevated fdg uptake in non tumorous lung regions does not predict immune checkpoint inhibitor related pneumonitis in lung cancer patients |
| topic | lung cancer NSCLC SCLC [18F]FDG-PET/CT standardized uptake value checkpoint inhibitor therapy |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2025.1563030/full |
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