Diagnostic impact of F-FDG PET/CT imaging on the detection of immune-related adverse events in patients treated with immunotherapy.

Publication date: May 20, 2022

Immunotherapy is an effective treatment method for cancer cells with humoral and cellular immune mechanisms of action but triggers an inflammatory response and disrupts standard protective immune tolerance. Early detection of immune-related adverse events (irAEs) on PET/CT is crucial for patient management and subsequent therapy decisions. In this study, we aimed to evaluate the impact of F-FDG PET/CT on detecting of irAEs in patients receiving immunotherapy. Forty-six patients with advanced RCC (n: 32), malign melanoma (n: 9), lung cancer (n: 4), and laryngeal carcinoma (n: 1), who underwent F-FDG PET/CT imaging for response assessment after immunotherapy, were enrolled in the study. Newly detected findings associated with irAEs on posttreatment PET/CT images were compared with the pretreatment PET/CT, both qualitatively and semi-quantitatively. Twenty-eight (61%) patients developed irAEs as observed on PET/CT. Enteritis/colitis was the most frequent irAE visualized on PET/CT with 13 patients (28. 2%), followed by gastritis (17. 3%), thyroiditis (13%), and myositis/arthritis (13%). Hepatitis (6. 5%), pneumonitis (6. 5%), sarcoid-like reaction (4. 3%), and hypophysitis (4. 3%) were observed to a lesser extent. The median time between the appearance of irAEs on PET/CT and the initiation of immunotherapy was 4. 3 months. There were no significant differences in age, sex, and treatment response status of patients with and without irAEs. F-FDG PET/CT plays a fundamental role in cancer immunotherapy with the potential to show significant irAEs both in the diagnosis and in follow-up of irAEs. IrAEs were present on PET/CT images of more than half of the patients who received immunotherapy in our study.

Concepts Keywords
Arthritis Lung cancer
Ct Molecular imaging
Immunotherapy Applied sciences
Newly Melanoma
Thyroiditis Medical imaging
PET-CT
Medical physics
Branches of biology
Neuroimaging
Imaging
Crucial patient management
Medicine

Semantics

Type Source Name
drug DRUGBANK Fludeoxyglucose F-18
disease MESH diagnosis
disease MESH hypophysitis
disease MESH pneumonitis
disease MESH Hepatitis
disease MESH arthritis
disease MESH myositis
disease MESH thyroiditis
disease MESH gastritis
disease MESH colitis
disease MESH Enteritis
disease MESH carcinoma
disease MESH lung cancer
pathway KEGG Melanoma
disease MESH melanoma
disease MESH immune tolerance
disease MESH cancer

Original Article

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