18F FDG PET/CT and Novel Molecular Imaging for Directing Immunotherapy in Cancer. August 2022-RY3042A-2022-Cook-SG

RY3042A-2022-Cook-SG

Pdf Summary

The study guide for Test 3042A covers the applications of 18F FDG PET/CT and novel molecular imaging techniques in directing immunotherapy for cancer patients. The guide includes questions regarding immune-related toxicities that may mimic cancer progression, such as pneumonitis, adrenalitis, sarcoid-like reactions, and hepatitis, with a particular focus on pneumonitis associated with immune checkpoint inhibitors (CPIs).<br /><br />Pneumonitis is a rare side effect of CPI and is most likely seen with certain drug combinations in specific conditions, such as combined Nivolumab and Ipilimumab treatment in stage IV non-small cell lung cancer (NSCLC). Understanding these associations assists in distinguishing true disease progression from side effects.<br /><br />The guide references the immune PET Response Criteria in Solid Tumors (PERCIST) criteria, which help in assessing treatment response. It specifically addresses the appropriate timeframe for confirming unconfirmed progressive metabolic disease (UPMD), suggesting re-imaging at 8–12 weeks.<br /><br />Furthermore, the guide discusses metabolic parameters assessed through 18F FDG PET/CT. Of these, the metabolic tumor volume is noted as a promising biomarker for determining the effectiveness of CPI therapy in terms of tumor burden.<br /><br />One of the questions focuses on the most critical immune imaging targets to overcome CPI resistance and reveal the tumor microenvironment. CD8 T cells are highlighted as a significant focus for investigation in this area, suggesting that insights into their behavior and presence might unlock new therapeutic avenues and improve treatment outcomes.<br /><br />This guide, although not qualifying for credit on its own, directs learners to further explore these topics through an online test at rsna.org/learning-center-ry, ensuring a comprehensive understanding of these advanced imaging techniques in cancer treatment.

Keywords

18F FDG PET/CT

molecular imaging

immunotherapy

immune-related toxicities

pneumonitis

immune checkpoint inhibitors

PERCIST criteria

metabolic tumor volume

CD8 T cells

cancer treatment