![Quantification of Atherosclerotic Plaque Activity and Vascular Inflammation using [18-F] Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography FDG-PET/CT](/_next/image?url=https%3A%2F%2Fcloudfront.jove.com%2FCDNSource%2Fteasers%2F3777.jpg&w=3840&q=50)
Pembrolizumab-induced vasculitis demonstrated by FDG-PET/CT
Tuan Vu1,2, Sophia R O'Brien1, Shawn X Ma1
1Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19147, USA.
Abstract:
A 76-year-old man with a history of malignant pleural mesothelioma treated with pembrolizumab underwent FDG-PET/CT for restaging. The images demonstrated FDG uptake overlying the right hepatic and splenic artery, which were new from the previous FDG-PET/CT 2.5 years prior before the patient started pembrolizumab, suspicious for vasculitis. A follow-up MRI supported the diagnosis with evidence of celiac, splenic, common hepatic, and right hepatic artery involvement. Pembrolizumab was discontinued and the patient received a short course of oral glucocorticoids. Subsequent FDG-PET/CT performed 14 months after initiation of treatment for vasculitis demonstrated resolution of vasculitis. Immune checkpoint inhibitors can cause vasculitis, which can be recognized on FDG-PET/CT and lead to appropriate treatment.
Insights
Pembrolizumab, an immune checkpoint inhibitor, can cause vasculitis. Fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) identified vasculitis in an immunotherapy patient, which resolved with treatment.
Area of Science:
- Oncology
- Immunology
- Radiology
Background:
- Malignant pleural mesothelioma is a rare and aggressive cancer.
- Immune checkpoint inhibitors (ICIs) like pembrolizumab have revolutionized cancer treatment.
- ICIs can induce immune-related adverse events, including vasculitis.
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