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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: 499; Downloads: 146
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Keywords: kemoterapija, rak debelega črevesa in danke, gastrointestinalni tumorji
Published in DiRROS: 14.07.2022; Views: 766; Downloads: 201
Full text (2,48 MB)

Keywords: melanom, rak kože, sistemsko zdravljenje
Published in DiRROS: 11.04.2022; Views: 543; Downloads: 157
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Keywords: onkologija, melanomi, maligni melanomi, UV žarki, sončenje, sončne opekline, zaščitne kreme
Published in DiRROS: 18.03.2022; Views: 682; Downloads: 234
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Abstract: V Sloveniji vsako leto zboli zaradi raka želodca okrog 450 bolnikov, od tega ima tri četrtine bolnikov ob postavitvi diagnoze razširjeno ali razsejano bolezen. Zato je pomembno, da imamo razvito sodobno multidisciplinarno zdravljenje. Onkološki inštitut je na poti pridobitve evropske onkološke akreditacije, ki jo podeljuje priznana Evropska organizacija onkoloških inštitutov (OECI), katere član je tudi Onkološki inštitut Ljubljana. Namen tega projekta je razvoj kliničnih poti, ki bodo omogočile celostno obravnavo bolnikov z rakom. Slovenskih priporočil za zdravljenje adenokarcinoma želodca trenutno nimamo, zato smo bili primorani sprejeti te, ki jim bomo sledili na Onkološkem inštitutu. V teh priporočilih, zaradi drugačne narave bolezni, ni zajeto zdravljenje raka ezofagogastričnega stika.
Keywords: rak želodca, adenokarcinom, onkološko zdravljenje, priporočila
Published in DiRROS: 14.09.2021; Views: 1387; Downloads: 368
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