Yang Chen, Zhu Fandong, Li Qianling, Sun Chenwen, Jin Hongyan, Zhao Zhenhua
Department of Radiology, Shaoxing People's Hospital, Shaoxing, China.
Department of Pathology, Shaoxing People's Hospital, Shaoxing, China.
Clin Respir J. 2025 Oct;19(10):e70125. doi: 10.1111/crj.70125.
The aim is to evaluate the expression of programmed death ligand 1 (PD-L1) in patients with non-small cell lung cancer (NSCLC) using quantitative perfusion parameters based on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI).
A total of 35 patients with a confirmed diagnosis of NSCLC and sufficient tissue pathology were enrolled in the study. The immunohistochemical (IHC) results were used as the gold standard to determine the thresholds for grouping the patients. The patients were divided into three categories based on their PD-L1 expression: (1) PD-L1-negative (IHC < 1%) and PD-L1-positive (IHC ≥ 1%); (2) PD-L1 weak (IHC < 50%) and strong expression (IHC ≥ 50%); and (3) PD-L1 nonexpression (IHC < 1%), low expression (IHC between 1% and 49%), and high expression (IHC ≥ 50%). DCE-MRI datasets were analyzed to acquire histogram parameters, including mean value, uniformity, skewness, kurtosis, entropy, energy, and quantity, of quantitative perfusion parameters using the extended Tofts model (ETM) and the exchange model (ECM). Subsequently, the parameters were compared between the aforementioned groups.
IHC showed PD-L1 < 1% in 20 cases, PD-L1 (1%-49%) in 14 cases, and PD-L1 ≥ 50% in 14 cases. At a threshold of 50%, statistically significant differences were observed for ETM/K (Q25 and Q50), ETM/K (Q10), and ECM/V (Q75 and Q90), with values being higher in the weak PD-L1 expression group. With thresholds of 1% and 50%, the results of the pairwise comparison showed that the ECM/V (Q75) value in the low PD-L1 expression group was significantly higher than that in the high PD-L1 expression group.
DCE-MRI quantitative analysis is a valuable tool for the evaluation of PD-L1 expression in NSCLC. It provides a noninvasive method that can be employed as an adjunctive technique for the stratification of PD-L1 expression in patients with NSCLC.
旨在基于动态对比增强磁共振成像（DCE-MRI）使用定量灌注参数评估非小细胞肺癌（NSCLC）患者中程序性死亡配体1（PD-L1）的表达。
共有35例确诊为NSCLC且有足够组织病理学资料的患者纳入本研究。免疫组织化学（IHC）结果用作确定患者分组阈值的金标准。根据患者的PD-L1表达将其分为三类：（1）PD-L1阴性（IHC＜1%）和PD-L1阳性（IHC≥1%）；（2）PD-L1弱表达（IHC＜50%）和强表达（IHC≥50%）；（3）PD-L1无表达（IHC＜1%）、低表达（IHC在1%至49%之间）和高表达（IHC≥50%）。使用扩展Tofts模型（ETM）和交换模型（ECM）分析DCE-MRI数据集，以获取定量灌注参数的直方图参数，包括平均值、均匀性、偏度、峰度、熵、能量和数量。随后，对上述组之间的参数进行比较。
IHC显示20例患者PD-L1＜1%，14例患者PD-L1（1%-49%），14例患者PD-L1≥50%。在50%的阈值下，观察到ETM/K（Q25和Q50）、ETM/K（Q10）和ECM/V（Q75和Q90）有统计学显著差异，PD-L1弱表达组的值更高。在1%和50%的阈值下，两两比较结果显示，PD-L1低表达组的ECM/V（Q75）值显著高于PD-L1高表达组。
DCE-MRI定量分析是评估NSCLC中PD-L1表达的有价值工具。它提供了一种非侵入性方法，可作为NSCLC患者PD-L1表达分层的辅助技术。
