CAR T-Cell Therapy: An Update for Radiologists.

Area of Science:

• Oncology
• Immunotherapy
• Radiology

Background:

• Chimeric antigen receptor (CAR) T-cell therapy is a rapidly advancing immunotherapy with FDA-approved treatments for various cancers.
• Despite its potential, CAR T-cell therapy is associated with significant toxicities, including cytokine release syndrome and neurotoxicity, necessitating early detection and management.

Purpose of the Study:

• To review the role of imaging in diagnosing and monitoring CAR T-cell therapy toxicities.
• To explore the utility of various imaging modalities, including PET/CT with novel radiotracers, in assessing treatment response and adverse effects.

Main Methods:

• Review of current literature on imaging findings in CAR T-cell therapy.
• Discussion of specific imaging techniques and their application in identifying and characterizing treatment-related toxicities and response patterns.

Main Results:

• Radiologists must recognize imaging findings associated with cytokine release syndrome and immune effector cell-associated neurotoxicity.
• Familiarity with typical and atypical treatment response patterns on imaging is essential for accurate patient management.

Conclusions:

• Imaging plays a vital role in the comprehensive management of patients undergoing CAR T-cell therapy.
• Radiologists need to be proficient in interpreting imaging findings related to CAR T-cell therapy to provide optimal clinical guidance.