1. Uporaba 18F - FDG PET/CT pri bolnikih z malignim melanomomKatarina Zevnik, 2023, published scientific conference contribution Abstract: Z odkritjem zaviralcev imunskih kontrolnih točk in z razvojem tarčno specifičnega zdravljenja so bili postavljeni novi mejniki v zdravljenju bolnikov z melanomom, ki predstavlja najbolj agresivno različico kožnega raka. Pomembno je zgodnje prepoznavanje metastatske bolezni zaradi hitre uvedbe ustreznega sistemskega zdravljenja. 18F - FDG PET/CT preiskava predstavlja uporabno slikovno metodo v diagnostiki melanoma, predvsem pri višjih izhodiščnih stadijih bolezni. Z uporabo določenih PET - parametrov (SUV max, MTV, TLG) lahko uspešno spremljamo odgovor na zdravljenje pri bolnikih na tarčni terapiji in imunoterapiji, v več študijah je je potrjena tudi prognostična napovedna vrednost določenih metaboličnih slikovnih biomarkerjev. PET/CT preiskava omogoča zgodnje prepoznavanje imunsko pogojenih neželenih učinkov pri bolnikih na zdravljenju z imunoterapijo, kar je pomembno za hitro ukinitev terapije in morebitno uvedbo ustrezne imunosupresivne terapije. Z razvojem molekularnih raziskav se odpirajo možnosti tudi v iskanju novih tarčno specifičnih PET - radiofarmakov za diagnostiko in terapijo malignega melanoma.
Keywords: rak kože, melanom, nuklearna medicina
Published in DiRROS: 17.05.2023; Views: 22; Downloads: 10
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2. Quantitative imaging biomarkers of immune-related adverse events in immune-checkpoint blockade-treated metastatic melanoma patients : a pilot studyNežka Hribernik, Daniel T. Huff, Andrej Studen, Katarina Zevnik, Žan Klaneček, Hamid Emamekhoo, Katja Škalič, Robert Jeraj, Martina Reberšek, 2022, original scientific article Abstract: Purpose: To develop quantitative molecular imaging biomarkers of immune-related adverse event (irAE) development in malignant melanoma (MM) patients receiving immune-checkpoint inhibitors (ICI) imaged with 18F-FDG PET/CT. Methods: 18F-FDG PET/CT images of 58 MM patients treated with anti-PD-1 or anti-CTLA-4 ICI were retrospectively analyzed for indication of irAE. Three target organs, most commonly affected by irAE, were considered: bowel, lung, and thyroid. Patient charts were reviewed to identify which patients experienced irAE, irAE grade, and time to irAE diagnosis. Target organs were segmented using a convolutional neural network (CNN), and novel quantitative imaging biomarkers - SUV percentiles (SUVX%) of 18F-FDG uptake within the target organs - were correlated with the clinical irAE status. Area under the receiver-operating characteristic curve (AUROC) was used to quantify irAE detection performance. Patients who did not experience irAE were used to establish normal ranges for target organ 18F-FDG uptake. Results: A total of 31% (18/58) patients experienced irAE in the three target organs: bowel (n=6), lung (n=5), and thyroid (n=9). Optimal percentiles for identifying irAE were bowel (SUV95%, AUROC=0.79), lung (SUV95%, AUROC=0.98), and thyroid (SUV75%, AUROC=0.88). Optimal cut-offs for irAE detection were bowel (SUV95%>2.7 g/mL), lung (SUV95%>1.7 g/mL), and thyroid (SUV75%>2.1 g/mL). Normal ranges (95% confidence interval) for the SUV percentiles in patients without irAE were bowel [1.74, 2.86 g/mL], lung [0.73, 1.46 g/mL], and thyroid [0.86, 1.99 g/mL]. Conclusions: Increased 18F-FDG uptake within irAE-affected organs provides predictive information about the development of irAE in MM patients receiving ICI and represents a potential quantitative imaging biomarker for irAE. Some irAE can be detected on 18F-FDG PET/CT well before clinical symptoms appear.
Keywords: melanoma, malignant melanoma, immune-checkpoint inhibitors, molecular imaging biomarkers
Published in DiRROS: 07.09.2022; Views: 211; Downloads: 74
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3. Posodobljena priporočila diagnostike in zdravljenja diferenciranega raka ščitniceNikola Bešić, Alenka Grošel, Andraž Perhavec, Andrej Doma, Andreja A. Schwarzbartl-Pevec, Andreja Klevišar Ivančič, Andrej Vogrin, Barbara Vidergar-Kralj, Barbara Gazić, Barbara Perić, Blaž Krhin, Cvetka Grašič-Kuhar, Edvard Pirnat, Ivana Žagar, Jerca Blazina, Katarina Zevnik, Katica Bajuk-Studen, Katja Zaletel, Margareta Strojan Fležar, Marko Hočevar, Marko Kokalj, Marta Dremelj, Nebojša Glumac, Olga Blatnik, Simona Gaberšček, Snežana Pavlović Djokić, Ulrika Klopčič, Veronika Kloboves-Prevodnik, Zorica Čekić, 2022, professional article Keywords: rak ščitnice, diferencirani rak, zdravljenje, smernice
Published in DiRROS: 01.07.2022; Views: 400; Downloads: 138
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