| Summary: | This study aimed to evaluate the prognostic significance of 2-Deoxy-2-[<sup>18</sup>F]fluoro-D-glucose ([<sup>18</sup>F]FDG) uptake in the bone marrow (BM) and primary tumors on dual-time-point (DTP) PET/CT for predicting progression-free survival (PFS) and distant metastasis-free survival (DMFS) in patients with non-small cell lung cancer (NSCLC). We retrospectively analyzed DTP [<sup>18</sup>F]FDG PET/CT images from 211 patients with NSCLC. The maximum standardized uptake value (SUV) of primary lung cancer and mean [<sup>18</sup>F]FDG uptake of the BM (BM SUV) were measured from early and delayed PET/CT images, and the percent changes in these parameters (∆maximum SUV and ∆BM SUV) were calculated. On multivariate survival analysis, the maximum SUV and BM SUV on both early and delayed PET/CT scans were significantly associated with PFS, while the ∆maximum SUV and ∆BM SUV failed to show statistical significance. For DMFS, the ∆maximum SUV and ∆BM SUV were independent predictors along with the TNM stage. Distant progression was observed only in 1.3% of patients with low ∆maximum SUV and ∆BM SUV, whereas 28.2% of patients with high ∆maximum SUV and ∆BM SUV experienced distant progression. The ∆maximum SUV and ∆BM SUV on DTP [<sup>18</sup>F]FDG PET/CT were significant independent predictors for DMFS in patients with NSCLC.
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