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@INPROCEEDINGS{Galldiks:864792,
      author       = {Galldiks, Norbert and Abdulla, D. S. Y. and Scheffler, M.
                      and Schweinsberg, V. and Schlaak, M. and Kreuzberg, N. and
                      Landsberg, J. and Lohmann, P. and Ceccon, G. and Werner, J.
                      M. and Celik, E. and Ruge, M. I. and Kocher, M. and Marnitz,
                      S. and Fink, G. R. and Langen, K. J. and Wolf, J. and Mauch,
                      C.},
      title        = {{T}reatment monitoring of immunotherapy and targeted
                      therapy using {FET} {PET} in patients with melanoma and lung
                      cancer brain metastases: {I}nitial experiences},
      reportid     = {FZJ-2019-04449},
      year         = {2019},
      abstract     = {Abstract:Background: Due to the lack of specificity of
                      contrast-enhanced (CE) MRI, the differentiation of
                      progression from pseudoprogression (PsP) following
                      immunotherapy using checkpoint inhibitors (IT) or targeted
                      therapy (TT) may be challenging, especially when IT or TT is
                      applied in combination with radiotherapy (RT). Similarly,
                      for response assessment of RT plus IT or targeted therapy
                      (TT), the use of CE MRI alone may also be difficult. For
                      problem solving, the integration of advanced imaging methods
                      may add valuable information. Here, we evaluated the value
                      of amino acid PET using O-(2-[18F]fluoroethyl)-L-tyrosine
                      (FET) in comparison to CE MRI for these important clinical
                      situations in patients with brain metastases (BM) secondary
                      to malignant melanoma (MM) and non-small cell lung cancer
                      (NSCLC). Methods: From 2015-2018, we retrospectively
                      identified 31 patients with 74 BM secondary to MM (n = 20
                      with 42 BM) and NSCLC (n = 11 with 32 BM) who underwent 52
                      FET PET scans during the course of disease. All patients had
                      RT prior to IT or TT initiation $(61\%)$ or RT concurrent to
                      IT or TT $(39\%).$ In 13 patients, FET PET was performed for
                      treatment response assessment of IT or TT using baseline and
                      follow-up scans (median time between scans, 4.2 months). In
                      the remaining 18 patients, FET PET was used for the
                      differentiation of progression from PsP related to RT plus
                      IT or TT. In all BM, metabolic activity on FET PET was
                      evaluated by calculation of tumor/brain ratios. FET PET
                      imaging findings were compared to CE MRI and correlated to
                      the clinical follow-up or neuropathological findings after
                      neuroimaging. Results: In 4 of 13 patients $(31\%),$ FET PET
                      provided additional information for treatment response
                      evaluation beyond the information provided by CE MRI alone.
                      Furthermore, responding patients on FET PET had a median
                      stable clinical follow-up of 10 months. In 10 of 18 patients
                      $(56\%)$ with CE MRI findings suggesting progression, FET
                      PET detected PsP. In 9 of these 10 patients, PsP was
                      confirmed by a median stable clinical follow-up of 11
                      months. Conclusions: FET PET may add valuable information
                      for treatment monitoring in individual BM patients
                      undergoing RT in combination with IT or TT.},
      month         = {May},
      date          = {2019-05-31},
      organization  = {2019 ASCO Annual Meeting, Chicago
                       (USA), 31 May 2019 - 4 Jun 2019},
      cin          = {INM-3 / INM-4},
      cid          = {I:(DE-Juel1)INM-3-20090406 / I:(DE-Juel1)INM-4-20090406},
      pnm          = {572 - (Dys-)function and Plasticity (POF3-572)},
      pid          = {G:(DE-HGF)POF3-572},
      typ          = {PUB:(DE-HGF)1},
      url          = {https://juser.fz-juelich.de/record/864792},
}