Fig. 4
Tracer uptake and correlation with PD1/PDL1 treatment response. a Study design. b Immunohistochemical staining of PD-L1 in patient 2. Biopsy of the tumor in the left lower lobe. PD-L1 expression is expressed in 95% of the tumor cells. Scale bar, 100 µm. c Immunohistochemical staining of PD-1 in patient 2. PD-1 expression in aggregates was scored as IC1. Scale bar, 100 µm. d 18F-FDG PET (225 MBq) (18F-FDG PET scan images of both patients were used from archival PET scans) demonstrates high glucose metabolism of tumors in both lungs and mediastinal lymph nodes. 18F-BMS-986192 PET (145.7 MBq, imaging time point 1 h post-injection (p.i.)) and 89Zr-labeled Nivolumab PET (37.09 MBq, 162 h p.i.) demonstrate heterogeneous tracer uptake within and between tumors. e Patient 3 with tumor PD-L1 expression < 1%: 18F-FDG PET (268 MBq) (18F-FDG PET scan images of both patients were used from archival PET scans) demonstrates high glucose metabolism in the left-sided tumor. 18F -BMS-986192 PET (214.62 MBq, 1 h p.i.) demonstrates low tumor tracer uptake. 89Zr-labeled Nivolumab PET (37.27 MBq, 160 h p.i.) demonstrates heterogeneous tracer uptake in the tumor. f SUVpeak of the 18F-BMS-986192 tracer is higher in responding lesions than non-responding lesions (comparison of lesions with a diameter of 20 mm or more). The p-value is 0.02, as determined by the Mann–Whitney U-test. SUVpeak of the 89Zr-nivolumab tracer is numerically higher in responding lesions (comparison of lesions with a diameter of 20 mm or more). The p-value is 0.019, as determined by the Mann–Whitney U-test. For all the boxplots, the lower edge of the box represents the first quartile, and the upper edge represents the third quartile. The horizontal line inside the box indicates the median. Whiskers identify the minimum and the maximum value. (Reproduced from Niemeijer, A. N. et al. Whole body PD-1 and PD-L1 positron emission tomography in patients with non-small-cell lung cancer. Nat. Commun. 9, 4664 (2018))
