Karlsen William, Akily Lin, Mierzejewska Monika, Teodorczyk Jacek, Bandura Artur, Zaucha Renata, Cytawa Wojciech
Students' Scientific Circle Department of Nuclear Medicine, Medical University of Gdańsk, 80-952 Gdańsk, Poland.
Department of Nuclear Medicine, Medical University of Gdańsk, 80-952 Gdańsk, Poland.
Cancers (Basel). 2024 May 24;16(11):1990. doi: 10.3390/cancers16111990.
Immunotherapy with immune checkpoint inhibitors (ICIs) has revolutionized contemporary oncology, presenting efficacy in various solid tumors and lymphomas. However, ICIs may potentially overstimulate the immune system, leading to immune-related adverse events (irAEs). IrAEs may affect multiple organs, such as the colon, stomach, small intestine, kidneys, skin, lungs, joints, liver, lymph nodes, bone marrow, brain, heart, and endocrine glands (e.g., pancreas, thyroid, or adrenal glands), exhibiting autoimmune inflammation. F-fluorodeoxyglucose positron emission tomography/computed tomography (F-FDG PET/CT) is commonly used in oncology for staging and assessment of therapy responses, but it may also serve as a tool for detecting irAEs. This review aims to present various patterns of metabolic activation associated with irAEs due to ICI treatment, identifiable through F-FDG PET/CT. It describes the advantages of early detection of irAEs, but also presents the challenges in differentiating them from tumor progression. It also delves into aspects of molecular response assessment within the context of pseudoprogression and hyperprogression, along with typical imaging findings related to these phenomena. Lastly, it summarizes the role of functional PET imaging in oncological immunotherapy, speculating on its future significance and limitations.
使用免疫检查点抑制剂（ICI）进行免疫治疗已经彻底改变了当代肿瘤学，在各种实体瘤和淋巴瘤中都显示出疗效。然而，ICI可能会过度刺激免疫系统，导致免疫相关不良事件（irAE）。irAE可能会影响多个器官，如结肠、胃、小肠、肾脏、皮肤、肺、关节、肝脏、淋巴结、骨髓、脑、心脏和内分泌腺（如胰腺、甲状腺或肾上腺），表现出自身免疫性炎症。氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（F-FDG PET/CT）在肿瘤学中常用于分期和评估治疗反应，但它也可作为检测irAE的工具。本综述旨在介绍因ICI治疗导致的与irAE相关的各种代谢激活模式，这些模式可通过F-FDG PET/CT识别。它描述了早期检测irAE的优势，但也提出了将它们与肿瘤进展区分开来的挑战。它还深入探讨了假进展和超进展背景下分子反应评估的各个方面，以及与这些现象相关的典型影像学表现。最后，它总结了功能性PET成像在肿瘤免疫治疗中的作用，推测其未来的意义和局限性。
