Baseline 18F FDG PET/CT imaging in NSCLC: Possible utility in predicting strong-positive PD-L1 expression

Background/Purpose: To assess whether 18F FDG PET/CT imaging can predict non-small cell lung cancer (NSCLC) patients with strong PD-L1 expression (≥50%). Methods: This retrospective study analyzed 149 NSCLC patients who had undergone baseline 18F FDG PET/CT imaging from June 2021 to May 2024. We recorded age, sex, smoking history, histopathology, TNM stage, metastasis, and PD-L1 expression levels. PET/CT parameters such as SUVmax, SUVmean, metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were recorded. Patients were dichotomized based on two PD-L1 expression thresholds, as measured by immunohistochemistry: higher or lower than 1% (1%, n = 87) and higher or lower than 50% (