Evidence map›Paper›PMID 40932611›Full record

SynthesisEuropean journal of nuclear medicine and molecular imaging2026

Diagnostic performance of 18F-FDG PET/CT metabolic parameters for early prediction of pathological response in NSCLC treated with neoadjuvant immuno(chemo)therapy: A systematic review and meta-analysis.

Hongsheng Deng, Zicong Deng, Ying Huang, Yu Jiang, Yuechun Lin, Runchen Wang, Jianqi Zheng, Junguo Dong, Zhi Zhang, Ailifeire Aihemaiti and 5 more

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in European journal of nuclear medicine and molecular imaging, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Hongsheng Deng *Department of Thoracic Surgery and Oncology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health, 151 Yanjiang Road, Guangzhou, 510120, China.
Zicong Deng *Department of Thoracic Surgery and Oncology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health, 151 Yanjiang Road, Guangzhou, 510120, China.
Ying HuangDepartment of Thoracic Surgery and Oncology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health, 151 Yanjiang Road, Guangzhou, 510120, China.
Yu JiangDepartment of Thoracic Surgery and Oncology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health, 151 Yanjiang Road, Guangzhou, 510120, China.
Yuechun LinDepartment of Thoracic Surgery and Oncology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health, 151 Yanjiang Road, Guangzhou, 510120, China.
Runchen WangDepartment of Thoracic Surgery and Oncology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health, 151 Yanjiang Road, Guangzhou, 510120, China.
Jianqi ZhengDepartment of Thoracic Surgery and Oncology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health, 151 Yanjiang Road, Guangzhou, 510120, China.
Junguo DongDepartment of Thoracic Surgery and Oncology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health, 151 Yanjiang Road, Guangzhou, 510120, China.
Zhi ZhangDepartment of Thoracic Surgery and Oncology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health, 151 Yanjiang Road, Guangzhou, 510120, China.
Ailifeire AihemaitiDepartment of Thoracic Surgery and Oncology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health, 151 Yanjiang Road, Guangzhou, 510120, China.
Chao YangDepartment of Thoracic Surgery and Oncology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health, 151 Yanjiang Road, Guangzhou, 510120, China.
Xin XuDepartment of Organ Transplantation & Department of Thoracic Surgery, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health, Guangzhou, China.
Wenhua LiangDepartment of Thoracic Surgery and Oncology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health, 151 Yanjiang Road, Guangzhou, 510120, China. liangwh1987@163.com.ORCID 0000-0002-1391-8238
Jianxing HeDepartment of Thoracic Surgery and Oncology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health, 151 Yanjiang Road, Guangzhou, 510120, China. drjianxing.he@gmail.com.ORCID 0000-0003-1737-8192
Hengrui LiangDepartment of Thoracic Surgery and Oncology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health, 151 Yanjiang Road, Guangzhou, 510120, China. hengrui_liang@163.com.

Funding

National Key R&D Program of China 2021YFC2500900/2021YFC2500901National Key R&D Program of China 2021YFC2500900/2021YFC2500905
6 · The paper itself

Abstract

purposeEarly and accurate prediction of pathological response in non-small cell lung cancer (NSCLC) receiving neoadjuvant immune(chemo)immunotherapy is essential for guiding treatment strategies. This meta-analysis aims to assess the predictive performance of PET/CT-derived metabolic parameters for identifying major pathological response (MPR) and pathological complete response (pCR).

methodsThe PubMed, Web of Science, Embase, and Cochrane Library were searched for related studies from inception to January 2025. Studies assessed evaluated predefined 18F-FDG PET/CT parameter (PERCIST, PERCIST-max, ΔSUVmax, ΔSULpeak, ΔSULmax, ΔMTV, ΔTLG, pre/post-treatment SUVmax, post-treatment SULmax/SULpeak) and reported pathological outcomes were included. Methodological quality was evaluated using QUADAS-2. Sensitivity, specificity and heterogeneity were analyzed via HSROC models. Publication bias was assessed via Deeks' test.

resultsSixteen studies met inclusion criteria. For MPR, PERCIST showed excellent sensitivity (1.00) but limited specificity (0.67), while PERCIST-max achieved both high sensitivity (0.92) and superior specificity (0.94). ΔSUVmax demonstrated balanced accuracy (sensitivity: 0.92; specificity: 0.77; AUC: 0.94), and ΔSULpeak also yielded high diagnostic performance (sensitivity: 0.94; specificity: 0.91). Volumetric metrics such as ΔMTV and ΔTLG showed variable results, with ΔMTV performing moderately (sensitivity: 0.77; specificity: 0.83), and ΔTLG exhibiting lower sensitivity (0.63) despite good specificity (0.81). For pCR, ΔSUVmax retained high sensitivity (0.94) but showed reduced specificity (0.57; AUC: 0.86). SUVmax-Pre showed moderate accuracy (sensitivity: 0.78; specificity: 0.81). Subgroup analyses indicated that the diagnostic performance of ΔSUVmax varied depending on treatment regimen.

conclusionsThe study support ΔSUVmax as a reliable indicator of MPR, although its specificity for pCR remains limited. PERCIST's high sensitivity aids in excluding non-responders. However, limited study numbers for parameters like ΔSULpeak, SULpeak-Post, and ΔSULmax reduce generalizability, necessitating larger validation studies to confirm their diagnostic utility.

Indexed as

Carcinoma, Non-Small-Cell LungFluorodeoxyglucose F18ImmunotherapyLung NeoplasmsNeoadjuvant TherapyPositron Emission Tomography Computed TomographyHumansTreatment OutcomeFluorodeoxyglucose F1818F-FDG PET/CTDiagnostic meta-analysisMetabolic parametersNeoadjuvant immunotherapyNon-small cell lung cancer

Identifiers

PMID40932611

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.