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Emerging and Evolving Concepts in Cancer Immunotherapy Imaging
Laurent Dercle1, Shawn Sun1, Romain-David Seban1
1From the Department of Radiology, New York Presbyterian Hospital-Columbia University Medical Center, 630 W 168th St, New York, NY 10032 (L.D., S.S., L.H.S.); Department of Nuclear Medicine, Institut Curie, Paris, France (R.D.S.); DMU Smart Imaging, Department of Medical Imaging, Assistance Publique-Hôpitaux de Paris, GH Université Paris-Saclay, Raymond Poincaré Teaching Hospital, Garches, France (A.M.); Gustave Roussy-Centrale Supélec-Therapanacea Centre of Artificial Intelligence in Radiation Therapy and Oncology, Gustave Roussy Cancer Campus, Villejuif, France (R.S.); Radiomics Team, Molecular Radiation Therapy INSERM U1030, Paris-Sud University, Gustave Roussy Cancer Campus, and University of Paris-Saclay, Villejuif, France (R.S.); Departments of Radiation Oncology (R.S.) and Interventional Radiology (L.T.), Gustave Roussy Cancer Campus, Villejuif, France; Department of Oncology, Henri Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Créteil, France (S.H.); Drug Development Department (DITEP), Gustave Roussy, Université Paris-Saclay, Villejuif, France (A.B.T.); Department of Radiology, Cochin Hospital, APHP, France (F.M.B.); Department of Nuclear Medicine, University Hospital, INSERM 1199 ANTICIPE, Normandy University, Caen, France (N.A.); Department of Nuclear Medicine, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France (L.V., A.R.); Department of Nuclear Medicine, Centre Eugène Marquis, Université Rennes 1, Rennes, France (A.G.); Department of Radiology, Rangueil University Hospital, Toulouse, France (F.Z.M.); Department of Hematology, University Hospital of Rennes, U1236, INSERM, Rennes, France (G.M., R.H.); EANM Oncology Committee, Vienna, Austria (E.L.); Department of Nuclear Medicine, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy (E.L.); Molecular Imaging and Therapy Service, Memorial Sloan Kettering Cancer Center, New York, NY (R.Y.); and Department of Medical Imaging, Diagnostic Imaging Service, Gustave Roussy, Université Paris Saclay, Villejuif, France (S.A.).
Immune checkpoint modulators offer new cancer treatments but alter traditional tumor size assessments. Advanced imaging techniques are crucial for accurately evaluating treatment response and managing novel immune-related effects.
Area of Science:
- Oncology
- Radiology
- Immunotherapy
Background:
- Traditional cancer treatment guidance relies on lesion diameter at CT, linked to survival.
- Immune checkpoint modulators (ICMs) represent a novel therapeutic paradigm for solid tumors.
- ICMs induce immune-related phenomena that challenge conventional tumor size-based response assessment.
Purpose of the Study:
- To review emerging imaging tools and strategies for evaluating immunotherapy response.
- To address challenges posed by novel imaging findings in immunotherapy, such as pseudoprogression and hyperprogression.
- To explore the integration of imaging biomarkers for improved clinical guidance and theranostic opportunities in immunotherapy.
Main Methods:
- Review of current research on imaging modalities for immunotherapy evaluation.
- Discussion of advanced applications of CT, MRI, and PET, including immuno-PET and radiomics.
- Exploration of multilevel integration of imaging with other biomarkers.
Main Results:
- Immunotherapy effects complicate the association between tumor size and treatment outcomes.
- New imaging approaches are needed to identify and manage immune-related adverse events and treatment responses.
- Emerging techniques like immuno-PET and radiomics show promise for enhanced evaluation.
Conclusions:
- Accurate imaging evaluation is critical for guiding immunotherapy treatment decisions.
- Advanced imaging modalities and biomarker integration can improve patient management and theranostics.
- Radiologists require new tools to interpret complex imaging patterns associated with immunotherapy.
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