Reassessing Patterns of Response to Immunotherapy with PET: From Morphology to Metabolism

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art_COSTA_Reassessing_Patterns_of_Response_to_Immunotherapy_with_PET_2021.PDF (6.02 MB)
Citações na Scopus
28
Tipo de produção
article
Data de publicação
2021
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
RADIOLOGICAL SOC NORTH AMERICA
Autores
COSTA, Larissa B.
BARBOSA, Felipe G.
NUNES, Rafael F.
ZANIBONI, Elaine C.
RUIZ, Mariana Mazo
JARDIM, Denis
Citação
RADIOGRAPHICS, v.41, n.1, p.120-143, 2021
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Cancer demands precise evaluation and accurate and timely assessment of response to treatment. Imaging must be performed early during therapy to allow adjustments to the course of treatment. For decades, cross-sectional imaging provided these answers, showing responses to the treatment through changes in tumor size. However, with the emergence of immune checkpoint inhibitors, complex immune response patterns were revealed that have quickly highlighted the limitations of this approach. Patterns of response beyond tumor size have been recognized and include cystic degeneration, necrosis, hemorrhage, and cavitation. Furthermore, new unique patterns of response have surfaced, like pseudoprogression and hyperprogression, while other patterns were shown to be deceptive, such as unconfirmed progressive disease. This evolution led to new therapeutic evaluation criteria adapted specifically for immunotherapy. Moreover, inflammatory adverse effects of the immune checkpoint blockade were identified, many of which were life threatening and requiring prompt intervention. Given complex concepts like tumor microenvironment and novel therapeutic modalities in the era of personalized medicine, increasingly sophisticated imaging techniques are required to address the intricate patterns of behavior of different neoplasms. Fluorine 18-fluorodeoxyglucose PET/CT has rapidly emerged as one such technique that spans both molecular biology and immunology. This imaging technique is potentially capable of identifying and tracking prognostic biomarkers owing to its combined use of anatomic and metabolic imaging, which enables it to characterize biologic processes in vivo. This tailored approach may provide whole-body quantification of the metabolic burden of disease, providing enhanced prediction of treatment response and improved detection of adverse events. (C) RSNA, 2020
Palavras-chave
URI
https://observatorio.fm.usp.br/handle/OPI/39148
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MDR
Artigos e Materiais de Revistas Científicas - HC/ICESP
Artigos e Materiais de Revistas Científicas - HC/InCor
Artigos e Materiais de Revistas Científicas - LIM/43
Artigos e Materiais de Revistas Científicas - LIM/44
Artigos e Materiais de Revistas Científicas - ODS/03