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@ARTICLE{Galldiks:878340,
author = {Galldiks, Norbert and Abdulla, Diana S. Y. and Scheffler,
Matthias and Schweinsberg, Viola and Schlaak, Max and
Kreuzberg, Nicole and Landsberg, Jennifer and Lohmann,
Philipp and Ceccon, Garry and Werner, Jan-Michael and Celik,
Eren and Ruge, Maximilian I. and Kocher, Martin and Marnitz,
Simone and Fink, Gereon R. and Langen, Karl-Josef and Wolf,
Juergen and Mauch, Cornelia},
title = {{T}reatment monitoring of immunotherapy and targeted
therapy using {FET} {PET} in patients with melanoma and lung
cancer brain metastases: {I}nitial experiences.},
journal = {Journal of nuclear medicine},
volume = {37},
number = {$15_suppl$},
issn = {0022-3123},
address = {New York, NY},
publisher = {Soc.},
reportid = {FZJ-2020-02789},
pages = {e13525 - e13525},
year = {2020},
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.},
cin = {INM-3 / INM-4},
ddc = {610},
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)16},
UT = {WOS:000487345800348},
doi = {10.1200/JCO.2019.37.15_suppl.e13525},
url = {https://juser.fz-juelich.de/record/878340},
}