Fig. 1

Study design, immunohistochemical staining of patient 2, and PET-images of patient 2 and 3. 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