Value of 2-[18F]FDG-PET/CT in identifying immune-related adverse events in patients with melanoma or non-small cell lung cancer: a systematic scoping review

IF 2.3 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Clinical and Translational Imaging Pub Date : 2024-02-09 DOI:10.1007/s40336-024-00618-3

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Abstract

Purpose

We aimed provide overview of the current literature regarding the diagnostic accuracy of 2-[¹⁸F]FDG-PET/CT in detecting immune-related adverse events (irAEs) in patients with metastatic melanoma or non-small cell lung cancer (NSCLC), receiving treatment with immune checkpoint inhibitors (ICIs).

Methods

Following PRISMA guidelines for scoping reviews, we first performed a comprehensive literature search in Medline (PubMed), Embase, and Scopus. After applying inclusion/exclusion criteria and abstract/full-text review, 7 articles with 478 patients with melanoma and 2 with 155 patients with NSCLC were included. The reference standard was irAE, corroborated clinically, biochemically, histologically, or on other imaging modalities.

Results

Melanoma: Five studies reported the sensitivity of 2-[¹⁸F]FDG-PET/CT, while two reported the prevalence of irAEs detected only by 2-[¹⁸F]FDG-PET/CT (without other verification of irAEs). The clinically reported prevalence of irAEs ranged from 1 to 18% for thyroiditis, 4–19% for colitis, and 3–9% for pneumonitis. The sensitivity of 2-[¹⁸F]FDG-PET/CT was 89–100% for thyroiditis, and 100% for colitis, pneumonitis, and sarcoid reaction in mediastinal lymph nodes. Only one study reported specificity and found a value of 49% for colitis, 96% for pneumonitis, and 81% for thyroiditis. NSCLC: The prevalence of 2-[18F]FDG-PET/CT detected irAEs 9–33% for thyroiditis, 34–40% for colitis, and 17–20% for pneumonitis. A sensitivity of 67% was found for thyroiditis. Results regarding specificity were lacking.

Conclusion

Studies suggested that 2-[¹⁸F]FDG-PET/CT is a valuable, non-invasive tool for detecting adverse events to anticancer treatment with ICIs. Sensitivity for the most commonly investigated irAEs, including thyroiditis, colitis, and pneumonitis, was generally high. Specificity was more varying and poorly reported. Prospective studies exploring the clinical impact are needed to determine the role and optimal timing of 2-[¹⁸F]FDG-PET/CT in identifying irAEs.

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2-[18F]FDG-PET/CT在识别黑色素瘤或非小细胞肺癌患者免疫相关不良事件中的价值：系统性范围界定综述

摘要目的我们旨在概述目前有关 2-[18F]FDG-PET/CT 在检测接受免疫检查点抑制剂（ICIs）治疗的转移性黑色素瘤或非小细胞肺癌（NSCLC）患者免疫相关不良事件（irAEs）诊断准确性的文献。方法按照范围界定综述的 PRISMA 指南，我们首先在 Medline (PubMed)、Embase 和 Scopus 中进行了全面的文献检索。在应用纳入/排除标准和摘要/全文审阅后，共纳入了 7 篇文章（478 名黑色素瘤患者）和 2 篇文章（155 名 NSCLC 患者）。参考标准为irAE，并通过临床、生化、组织学或其他成像方式加以证实。结果黑色素瘤：五项研究报告了2-[18F]FDG-PET/CT的灵敏度，两项研究报告了仅通过2-[18F]FDG-PET/CT检测到的虹膜AE的患病率（未对虹膜AE进行其他验证）。临床报告的虹膜睫状体异常发病率为：甲状腺炎 1%-18%，结肠炎 4%-19%，肺炎 3%-9%。2-[18F]FDG-PET/CT对甲状腺炎的敏感性为89%-100%，对结肠炎、肺炎和纵隔淋巴结肉样瘤反应的敏感性为100%。只有一项研究报告了特异性，发现结肠炎的特异性为 49%，肺炎的特异性为 96%，甲状腺炎的特异性为 81%。NSCLC：2-[18F]FDG-PET/CT检测到的irAEs发生率为：甲状腺炎9-33%，结肠炎34-40%，肺炎17-20%。甲状腺炎的灵敏度为 67%。缺乏有关特异性的结果。结论研究表明，2-[18F]FDG-PET/CT 是检测 ICIs 抗癌治疗不良反应的重要非侵入性工具。对甲状腺炎、结肠炎和气管炎等最常见的虹膜不良反应的灵敏度普遍较高。特异性则参差不齐，报告较少。需要进行探索临床影响的前瞻性研究，以确定 2-[18F]FDG-PET/CT 在识别虹膜不良反应方面的作用和最佳时机。

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来源期刊

Clinical and Translational Imaging Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

3.60

自引率

4.80%

发文量

期刊介绍： Clinical and Translational Imaging is an international journal that publishes timely, up-to-date summaries on clinical practice and translational research and clinical applications of approved and experimental radiopharmaceuticals for diagnostic and therapeutic purposes. Coverage includes such topics as advanced preclinical evidence in the fields of physics, dosimetry, radiation biology and radiopharmacy with relevance to applications in human subjects. The journal benefits a readership of nuclear medicine practitioners and allied professionals involved in molecular imaging and therapy.