Immune checkpoint inhibitors (ICIs), targeting programmed cell death protein-1 (PD-1) and its ligand (PD-L1), have changed the treatment history of lung cancer, especially in the field of non-small cell lung cancer (NSCLC). 18 F-FDG PET/CT, as a noninvasive and effective examination technique, reflects the location and functional information of tumor lesions through the metabolic level of glucose. Studies have shown that PD-L1 may affect the sugar metabolism of tumor cells. Therefore, 18 F-FDG PET/CT can be used to predict the expression of PD-L1 and evaluate the efficacy of immunotherapy. This article mainly introduces the relationship between PD-L1 expression and NSCLC, the advantages of 18 F-FDG PET/CT, the imaging mechanism of 18 F-FDG PET/CT based on PD-L1 and its research progress in NSCLC, and the role of 18 F-FDG PET/CT in the response and efficacy evaluation of immunotherapy in NSCLC, aiming to provide a reference for the clinic.
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