{
    "abstract": "This study aimed to assess whether pharmacokinetic parameters derived from DCE-MRI can stratify Programmed Death-Ligand 1 (PD-L1) expression in NSCLC. The secondary aim was to identify a suitable pharmacokinetic model configuration for anisotropic temporally-spaced DCE-MRI sequences, considering Tofts variants, population-averaged arterial input functions (AIF), and bolus arrival time (BAT) estimation methods.\nFrom April 2021 to May 2023, patients with locally advanced non-small cell lung cancer (NSCLC) were prospectively enrolled. Tumors were categorized based on: PD-L1 absence/presence (threshold 1%) and hyperexpression/hypoexpression (threshold 50%). Pharmacokinetic parameters were extracted using several candidate configurations; fit quality was evaluated using coefficient of determination (R\u00b2). Mann-Whitney U-test and ROC-AUC were used to assess correlation with PD-L1 for the best-fit configuration.\nThirty-eight patients (mean age 68\u2009\u00b1\u20099 years, 28 men) were included. PD-L1 expression was present in 25 patients (66%) and absent in 13 (34%). PD-L1 was hyperexpressed in 13 (34%) patients and hypoexpressed in 25 (66%). Voxel-wise pharmacokinetic parameters were extracted using the best-fit configuration-extended Tofts model (ETM) with Georgiou AIF and Peak-Gradient (PG) BAT estimation (R\nDCE-MRI pharmacokinetic parameters could stratify PD-L1 hypo/hyperexpression in NSCLC. The ETM with PG BAT estimation method and Georgiou AIF was the best-performing pharmacokinetic configuration.\nQuestion Could Dynamic Contrast-Enhanced (DCE) MRI offer a safe and non-invasive way to assess Programmed Death-Ligand 1 (PD-L1) expression? Findings Quantitative DCE-MRI parameters K",
    "authors": [
        {
            "affiliation": "Diagnostic Imaging and Radiotherapy Unit, Department of Clinical, Surgical, Diagnostic, and Pediatric Sciences, University of Pavia, Pavia, Italy.",
            "firstname": "Gaia",
            "initials": "G",
            "lastname": "Messana"
        },
        {
            "affiliation": "Diagnostic Imaging and Radiotherapy Unit, Department of Clinical, Surgical, Diagnostic, and Pediatric Sciences, University of Pavia, Pavia, Italy.\nRadiology Institute, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.",
            "firstname": "Chandra",
            "initials": "C",
            "lastname": "Bortolotto"
        },
        {
            "affiliation": "Diagnostic Imaging and Radiotherapy Unit, Department of Clinical, Surgical, Diagnostic, and Pediatric Sciences, University of Pavia, Pavia, Italy. sithin.thulasiseetha@unipv.it.\nClinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy. sithin.thulasiseetha@unipv.it.",
            "firstname": "Sithin",
            "initials": "S",
            "lastname": "Thulasi Seetha"
        },
        {
            "affiliation": "Diagnostic Imaging and Radiotherapy Unit, Department of Clinical, Surgical, Diagnostic, and Pediatric Sciences, University of Pavia, Pavia, Italy.",
            "firstname": "Alessandra",
            "initials": "A",
            "lastname": "Marrocco"
        },
        {
            "affiliation": "Diagnostic Imaging and Radiotherapy Unit, Department of Clinical, Surgical, Diagnostic, and Pediatric Sciences, University of Pavia, Pavia, Italy.",
            "firstname": "Carlotta",
            "initials": "C",
            "lastname": "Pairazzi"
        },
        {
            "affiliation": "UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, University of California Los Angeles, Los Angeles, CA, USA.\nDepartment of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.",
            "firstname": "Francesco",
            "initials": "F",
            "lastname": "Sanvito"
        },
        {
            "affiliation": "Department of Physics, University of Pavia, Pavia, Italy.\nIstituto Nazionale Di Fisica Nucleare, Sezione Di Pavia, Pavia, Italy.",
            "firstname": "Francesca",
            "initials": "F",
            "lastname": "Brero"
        },
        {
            "affiliation": "Department of Physics, University of Pavia, Pavia, Italy.\nIstituto Nazionale Di Fisica Nucleare, Sezione Di Pavia, Pavia, Italy.",
            "firstname": "Agnese",
            "initials": "A",
            "lastname": "Robustelli Test"
        },
        {
            "affiliation": "Euler Institute, Universit\u00e0 della Svizzera Italiana, Lugano, Switzerland.",
            "firstname": "Raffaella Fiamma",
            "initials": "RF",
            "lastname": "Cabini"
        },
        {
            "affiliation": "Department of Physics, University of Pavia, Pavia, Italy.\nIstituto Nazionale Di Fisica Nucleare, Sezione Di Pavia, Pavia, Italy.",
            "firstname": "Alessandro",
            "initials": "A",
            "lastname": "Lascialfari"
        },
        {
            "affiliation": "Siemens Healthcare srl, Milano, Italy.",
            "firstname": "Domenico",
            "initials": "D",
            "lastname": "Zac\u00e0"
        },
        {
            "affiliation": "Department of Medical Sciences and Infective Diseases, Unit of Respiratory Diseases, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.\nDepartment of Internal Medicine and Medical Therapeutics, University of Pavia, Pavia, Italy.",
            "firstname": "Giulia Maria",
            "initials": "GM",
            "lastname": "Stella"
        },
        {
            "affiliation": "Department of Medical Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.",
            "firstname": "Francesco",
            "initials": "F",
            "lastname": "Agustoni"
        },
        {
            "affiliation": "Radiation Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.",
            "firstname": "Jessica",
            "initials": "J",
            "lastname": "Saddi"
        },
        {
            "affiliation": "Diagnostic Imaging and Radiotherapy Unit, Department of Clinical, Surgical, Diagnostic, and Pediatric Sciences, University of Pavia, Pavia, Italy.\nRadiation Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.\nRadiation Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.\nDepartment of Oncology, University of Milan, Milan, Italy.",
            "firstname": "Andrea Riccardo",
            "initials": "AR",
            "lastname": "Filippi"
        },
        {
            "affiliation": "Diagnostic Imaging and Radiotherapy Unit, Department of Clinical, Surgical, Diagnostic, and Pediatric Sciences, University of Pavia, Pavia, Italy.\nRadiology Institute, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.",
            "firstname": "Lorenzo",
            "initials": "L",
            "lastname": "Preda"
        }
    ],
    "conclusions": "DCE-MRI pharmacokinetic parameters could stratify PD-L1 hypo/hyperexpression in NSCLC. The ETM with PG BAT estimation method and Georgiou AIF was the best-performing pharmacokinetic configuration.",
    "copyrights": "\u00a9 2025. The Author(s).",
    "doi": "10.1007/s00330-025-11524-1\n10.3322/caac.21834\n10.1038/nature14011\n10.1056/NEJMoa1501824\n10.1016/S0140-6736(15)01281-7\n10.21037/tlcr.2017.03.01\n10.1007/s00432-022-04080-4\n10.6004/jnccn.2022.0025\n10.1200/JCO.21.00174\n10.1177/03936155231214273\n10.3389/pore.2023.1611001\n10.2478/raon-2021-0005\n10.1007/s00330-023-10102-7\n10.1186/s12967-020-02241-y\n10.1186/s12880-018-0267-3\n10.1002/mrm.21066\n10.1007/s00330-023-10215-z\n10.3978/j.issn.2223-3652.2014.03.01\n10.1002/mrm.22861\n10.4261/1305-3825.DIR.2537-08.1\n10.7150/jca.88367\n10.1038/s41598-024-55033-5\n10.3389/fonc.2018.00367\n10.1054/bjoc.1999.1129\n10.2214/AJR.12.9543\n10.1016/j.diii.2013.10.010\n10.21873/anticanres.12543\n10.1186/s40644-021-00429-z\n10.1172/jci.insight.89014\n10.1002/jmri.25034\n10.1038/s41598-022-12582-x\n10.1002/jmri.26518",
    "journal": "European radiology",
    "keywords": [
        "Immunotherapy",
        "Non-small cell lung carcinoma",
        "PD-L1 inhibitors",
        "Perfusion magnetic resonance imaging",
        "Pharmacokinetics"
    ],
    "methods": null,
    "publication_date": "2025-03-27",
    "pubmed_id": "40146425\n38572751\n25428504\n25891174\n26712084\n28529902\n35708777\n35545176\n33872070\n38111297\n37342362\n33764703\n37566270\n32013991\n30092765\n6505043\n17036301\n37882836\n24834412\n21384424\n19885783\n37859821\n38396128\n30250827\n10780522\n23255738\n24211260\n29715121\n34801089\n27699239\n26303794\n35610281\n30451345",
    "results": "Thirty-eight patients (mean age 68\u2009\u00b1\u20099 years, 28 men) were included. PD-L1 expression was present in 25 patients (66%) and absent in 13 (34%). PD-L1 was hyperexpressed in 13 (34%) patients and hypoexpressed in 25 (66%). Voxel-wise pharmacokinetic parameters were extracted using the best-fit configuration-extended Tofts model (ETM) with Georgiou AIF and Peak-Gradient (PG) BAT estimation (R",
    "title": "Non-invasive PD-L1 stratification in non-small cell lung cancer using dynamic contrast-enhanced MRI.",
    "xml": "<Element 'PubmedArticle' at 0x7885029fa3e0>"
}