PET/CT imaging for evaluation of multimodal treatment efficacy and toxicity in advanced NSCLC—current state and future directions
FDG PET/CT is a valuable tool for evaluating treatment efficacy and toxicity in advanced NSCLC, but current FBG‑PET based response criteria lack standardization and need refinement for optimal clinical use.
The advent of immune checkpoint inhibitors (ICIs) has revolutionized the treatment of advanced NSCLC, leading to a string of approvals in recent years. Herein, a narrative review on the role of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) in the ever‑evolving treatment landscape of advanced NSCLC is presented. The review summarizes current treatment paradigms incorporating ICIs, the evolution of CT‑based criteria, novel phenomena observed with ICIs and the current state of hybrid imaging for diagnosis, treatment planning, evaluation of treatment efficacy and toxicity in advanced NSCLC, along with limitations and future directions. FDG PET/CT is widely adopted for tumor volume delineation in locally advanced disease, response assessment to immunotherapy based on current criteria is of high clinical value but has its inherent limitations. In recent years, modifications of established (PET/CT) criteria have been proposed to provide more refined approaches toward response evaluation. Prospective randomized controlled trials incorporating PET‑based response criteria and harmonization of various PET‑based response criteria are essential to strengthen clinical implementation and widespread use of hybrid imaging for response assessment in NSCLC.
Accurate assessment of treatment response and toxicity monitoring in advanced NSCLC using FDG PET/CT can guide clinical decision‑making, optimize therapeutic strategies, and potentially improve patient outcomes.
Bizonyítékszint: Állatkísérletes. Állatmodellben vizsgálták.
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