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Lee EYP, Philip Ip PC, Tse KY, Kwok ST, Chiu WK, Ho G. PET/Computed Tomography Transformation of Oncology: Ovarian Cancers. PET Clin 2024; 19:207-216. [PMID: 38177053 DOI: 10.1016/j.cpet.2023.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Abstract
Over the last quarter of a century, fluorine-18-fluorodeoxyglucose (FDG) PET/computed tomography (CT) has revolutionized the diagnostic algorithm of ovarian cancer, impacting on the initial disease evaluation including staging and surgical planning, treatment response assessment and prognostication, to the most important role in detection of recurrent disease. The role of FDG PET/CT is expanding with the adoption of new therapeutic agents. Other non-FDG tracers have been explored with fibroblast activation protein inhibitor being promising. Novel tracers may provide the basis for future theragnostic work. This article will review the evolution and impact of PET/CT in ovarian cancer management.
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Affiliation(s)
- Elaine Yuen Phin Lee
- Department of Diagnostic Radiology, School of Clinical Medicine, University of Hong Kong, Room 406, Block K, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong SAR, China.
| | - Pun Ching Philip Ip
- Department of Pathology, School of Clinical Medicine, University of Hong Kong, Room 019, 7/F, Block T, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong SAR, China
| | - Ka Yu Tse
- Department of Obstetrics and Gynaecology, School of Clinical Medicine, University of Hong Kong, 6/F, Professorial Block, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong SAR, China
| | - Shuk Tak Kwok
- Department of Obstetrics and Gynaecology, 6/F, Professorial Block, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong SAR, China
| | - Wan Kam Chiu
- Department of Obstetrics and Gynaecology, United Christian Hospital, 5/F, Block S, Kwun Tong, Kowloon, Hong Kong, China
| | - Grace Ho
- Department of Radiology, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong SAR, China
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Mallio CA, Bernetti C, Cea L, Buoso A, Stiffi M, Vertulli D, Greco F, Zobel BB. Adverse Effects of Immune-Checkpoint Inhibitors: A Comprehensive Imaging-Oriented Review. Curr Oncol 2023; 30:4700-4723. [PMID: 37232813 DOI: 10.3390/curroncol30050355] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 04/22/2023] [Accepted: 05/01/2023] [Indexed: 05/27/2023] Open
Abstract
Immune-checkpoint inhibitors (ICIs) are immunomodulatory monoclonal antibodies, which increase antitumor immunity of the host and facilitate T-cell-mediated actions against tumors. These medications have been used in recent years as a weapon against advanced stage malignancies, such as melanoma, renal cell carcinoma, lymphoma, small or non-small cell lung cancer, and colorectal cancer. Unfortunately, they are not free from possible adverse effects (immune-related adverse events-irAEs) that mainly affect skin, gastrointestinal, hepatic, and endocrine systems. Early diagnosis of irAEs is essential to correctly and rapidly manage patients, with ICIs suspension and therapies administration. Deep knowledge of the imaging and clinical patterns of irAEs is the key to promptly rule out other diagnoses. Here, we performed a review of the radiological signs and differential diagnosis, based on the organ involved. The aim of this review is to provide guidance to recognize the most significant radiological findings of the main irAEs, based on incidence, severity, and the role of imaging.
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Affiliation(s)
- Carlo Augusto Mallio
- Department of Medicine and Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
- Department of Medicine and Surgery, Research Unit of Radiology, Università Campus Bio-Medico di Roma, 00128 Roma, Italy
| | - Caterina Bernetti
- Department of Medicine and Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
- Department of Medicine and Surgery, Research Unit of Radiology, Università Campus Bio-Medico di Roma, 00128 Roma, Italy
| | - Laura Cea
- Department of Medicine and Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
- Department of Medicine and Surgery, Research Unit of Radiology, Università Campus Bio-Medico di Roma, 00128 Roma, Italy
| | - Andrea Buoso
- Department of Medicine and Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
- Department of Medicine and Surgery, Research Unit of Radiology, Università Campus Bio-Medico di Roma, 00128 Roma, Italy
| | - Massimo Stiffi
- Department of Medicine and Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
- Department of Medicine and Surgery, Research Unit of Radiology, Università Campus Bio-Medico di Roma, 00128 Roma, Italy
| | - Daniele Vertulli
- Department of Medicine and Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
- Department of Medicine and Surgery, Research Unit of Radiology, Università Campus Bio-Medico di Roma, 00128 Roma, Italy
| | - Federico Greco
- Unità Operativa Complessa Diagnostica per Immagini Territoriale Aziendale, Cittadella della Salute Azienda Sanitaria Locale di Lecce, Piazza Filippo Bottazzi, 73100 Lecce, Italy
| | - Bruno Beomonte Zobel
- Department of Medicine and Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
- Department of Medicine and Surgery, Research Unit of Radiology, Università Campus Bio-Medico di Roma, 00128 Roma, Italy
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Khessib T, Franc B, Yang E, Moradi F. Retroperitoneal Inflammation Detected on FDG PET/CT in Patient on Long-Term Immunotherapy. Clin Nucl Med 2023; 48:e165-e166. [PMID: 36728374 DOI: 10.1097/rlu.0000000000004513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
ABSTRACT A 68-year-old man with a history of pulmonary adenocarcinoma on maintenance pembrolizumab presented for surveillance imaging. 18 F-FDG PET/CT demonstrated new ill-defined right retroperitoneal and presacral soft tissue stranding with associated FDG uptake suggestive of inflammation. Biopsy results revealed fibroadipose tissue with extensive lymphoplasmacytic inflammation concerning for immunotherapy-related toxicity. The patient was subsequently taken off pembrolizumab, which he had been on for approximately 3 years. Recognition of immunotherapy-related adverse effects and how they can manifest on 18 F-FDG PET/CT is important for prompt cessation of treatment.
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Affiliation(s)
- Tasnim Khessib
- From the Division of Nuclear Medicine and Molecular Imaging, Department of Radiology
| | - Benjamin Franc
- From the Division of Nuclear Medicine and Molecular Imaging, Department of Radiology
| | - Eric Yang
- Division of Surgical Pathology, Department of Pathology, Stanford Health Care, Palo Alto, CA
| | - Farshad Moradi
- From the Division of Nuclear Medicine and Molecular Imaging, Department of Radiology
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Kim N, Lee ES, Won SE, Yang M, Lee AJ, Shin Y, Ko Y, Pyo J, Park HJ, Kim KW. Evolution of Radiological Treatment Response Assessments for Cancer Immunotherapy: From iRECIST to Radiomics and Artificial Intelligence. Korean J Radiol 2022; 23:1089-1101. [PMID: 36098343 PMCID: PMC9614294 DOI: 10.3348/kjr.2022.0225] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 08/11/2022] [Accepted: 08/12/2022] [Indexed: 12/24/2022] Open
Abstract
Immunotherapy has revolutionized and opened a new paradigm for cancer treatment. In the era of immunotherapy and molecular targeted therapy, precision medicine has gained emphasis, and an early response assessment is a key element of this approach. Treatment response assessment for immunotherapy is challenging for radiologists because of the rapid development of immunotherapeutic agents, from immune checkpoint inhibitors to chimeric antigen receptor-T cells, with which many radiologists may not be familiar, and the atypical responses to therapy, such as pseudoprogression and hyperprogression. Therefore, new response assessment methods such as immune response assessment, functional/molecular imaging biomarkers, and artificial intelligence (including radiomics and machine learning approaches) have been developed and investigated. Radiologists should be aware of recent trends in immunotherapy development and new response assessment methods.
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Affiliation(s)
- Nari Kim
- Department of Medical Science, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.,Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Eun Sung Lee
- Department of Medical Science, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.,Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Sang Eun Won
- Department of Medical Science, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.,Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Mihyun Yang
- Department of Medical Science, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.,Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Amy Junghyun Lee
- Department of Medical Science, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.,Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Youngbin Shin
- Department of Medical Science, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.,Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Yousun Ko
- Department of Medical Science, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.,Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Junhee Pyo
- Department of Medical Science, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyo Jung Park
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Kyung Won Kim
- Department of Medical Science, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.,Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
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