The Role of Nuclear Medicine in Predicting Treatment Response to Immunotherapy and Targeted Therapy in Hepatocellular Carcinoma: A Narrative Review.

Objective: Targeted and immunotherapy offer new treatment options for patients with advanced hepatocellular carcinoma (HCC); however, the proportion of patients who benefit from these therapies remains limited. Moreover, these treatments can involve complications and add financial burdens to patients, underscoring the need to identify those who are likely to benefit. As an advanced molecular imaging technique, nuclear medicine has the potential to predict treatment efficacy in targeted and immunotherapy, though its predictive accuracy remains uncertain. This narrative review aims to summarize existing research on nuclear medicine applications in this area, providing clinicians with new perspectives. Materials and Methods: We conducted a literature review across multiple medical databases, including PubMed, Embase, Cochrane Library, Web of Science, and Scopus. Relevant studies were identified, organized, and summarized to present findings in the field. Results: The findings indicate that metrics such as maximum standardized uptake value (SUVmax) and metabolic tumor volume (MTV) correlate with the efficacy of targeted and immunotherapy. Additionally, emerging nuclear medicine techniques have shown promise in predicting PD-L1 expression. Conclusion: Nuclear medicine holds potential for identifying patients who are likely to benefit from targeted and immunotherapy. However, further refinements are necessary to optimize its predictive capabilities.