Computed tomography imaging findings of nivolumab-induced thyroid dysfunction

Area of Science:

• Oncology
• Endocrinology
• Radiology

Background:

• Immune-related adverse events (irAEs) are common with nivolumab therapy.
• The thyroid gland is frequently affected by nivolumab-induced irAEs.

Purpose of the Study:

• To investigate changes in thyroid function, volume, and CT attenuation in patients treated with nivolumab.
• To correlate imaging findings with nivolumab-induced thyroid dysfunction.

Main Methods:

• Retrospective review of 24 patients treated with nivolumab for lung cancer or renal cell carcinoma.
• Analysis of thyroid function tests and thyroid gland volume/attenuation on serial computed tomography (CT) scans.

Main Results:

• Four patients (16.7%) developed nivolumab-induced thyroid dysfunction (hypothyroidism or hyperthyroidism).
• Hypothyroidism was associated with reduced thyroid volume and diminished CT attenuation in one case.
• Hyperthyroidism showed varied effects on thyroid volume.
• Thyroid volume changes were also observed in patients without thyroid dysfunction.

Conclusions:

• Radiologists should be aware of potential thyroid volume and CT attenuation changes associated with nivolumab therapy.
• These imaging changes can indicate nivolumab-induced thyroid dysfunction.
• Thyroid volume may fluctuate during nivolumab treatment, irrespective of thyroid function status.