Table_1_The role of 18F−FDG PET in predicting the pathological response and prognosis to unresectable HCC patients treated with lenvatinib and PD-1 inhibitors as a conversion therapy.docx

PurposeTo investigate the diagnostic value of 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET), as an imaging biomarker, for predicting pathological response and prognosis of unresectable hepatocellular carcinoma (HCC) patients treated with Lenvatinib and programmed cell death protein 1 (PD-1) inhibitors as a conversion therapy.MethodsA total of 28 unresectable HCC patients with BCLC stage B or C were treated with Lenvatinib and PD-1 inhibitors before surgery. The 18F-FDG PET/CT scans were acquired before pre- (scan-1) and post-conversion therapy (scan-2). The maximum standardized uptake value (SUVmax), TLR (tumor-to-normal liver standardized uptake value ratio), and the percentages of post-treatment changes in metabolic parameters (ΔSUVmax [%] and ΔTLR [%]) were calculated. Major pathological response (MPR) was identified based on the residual viable tumor in the resected primary tumor specimen (≤10%). Differences in the progression-free survival (PFS) and overall survival (OS) stratified by ΔTLR were examined by the Kaplan-Meier method.Results11 (11/28, 39.3%) patients were considered as MPR responders and 17 (17/28, 60.7%) patients as non-MPR responders after conversion therapy. ΔSUVmax (-70.0 [-78.8, -48.8] vs. -21.7 [-38.8, 5.7], respectively; P

本研究旨在探讨^{18}F-氟代脱氧葡萄糖正电子发射断层扫描（^{18}F-FDG PET）作为影像生物标志物，在预测不可切除性肝细胞癌（HCC）患者经伦伐替尼及程序性细胞死亡蛋白1（PD-1）抑制剂转化治疗后的病理学反应及预后的诊断价值。方法：共纳入28例BCLC分期B或C期的不可切除性HCC患者，在接受手术前接受伦伐替尼和PD-1抑制剂治疗。在术前（扫描1）和转化治疗结束后（扫描2）进行^{18}F-FDG PET/CT扫描。计算最大标准化摄取值（SUVmax）、肿瘤与正常肝脏标准化摄取值比（TLR）及治疗前后代谢参数变化百分比（ΔSUVmax [%]和ΔTLR [%]）。基于切除的原发肿瘤标本中残留的存活肿瘤量（≤10%）确定主要病理反应（MPR）。通过Kaplan-Meier方法分析按ΔTLR分层后的无进展生存期（PFS）和总生存期（OS）的差异。结果：在转化治疗后，11例（11/28，39.3%）患者被认定为MPR反应者，17例（17/28，60.7%）患者被认定为非MPR反应者。ΔSUVmax分别为（-70.0 [-78.8, -48.8] vs. -21.7 [-38.8, 5.7]，P