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European Journal of Nuclear Medicine and Molecular Imaging

Published in:

Open Access 01-11-2021 | NSCLC | Review Article

PET/CT imaging for evaluation of multimodal treatment efficacy and toxicity in advanced NSCLC—current state and future directions

Authors: Chukwuka Eze, Nina-Sophie Schmidt-Hegemann, Lino Morris Sawicki, Julian Kirchner, Olarn Roengvoraphoj, Lukas Käsmann, Lena M. Mittlmeier, Wolfgang G. Kunz, Amanda Tufman, Julien Dinkel, Jens Ricke, Claus Belka, Farkhad Manapov, Marcus Unterrainer

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 12/2021

Abstract

Purpose

The advent of immune checkpoint inhibitors (ICIs) has revolutionized the treatment of advanced NSCLC, leading to a string of approvals in recent years. Herein, a narrative review on the role of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) in the ever-evolving treatment landscape of advanced NSCLC is presented.

Methods

This comprehensive review will begin with an introduction into current treatment paradigms incorporating ICIs; the evolution of CT-based criteria; moving onto novel phenomena observed with ICIs and the current state of hybrid imaging for diagnosis, treatment planning, evaluation of treatment efficacy and toxicity in advanced NSCLC, also taking into consideration its limitations and future directions.

Conclusions

The advent of ICIs marks the dawn of a new era bringing forth new challenges particularly vis-à-vis treatment response assessment and observation of novel phenomena accompanied by novel systemic side effects. While FDG PET/CT is widely adopted for tumor volume delineation in locally advanced disease, response assessment to immunotherapy based on current criteria is of high clinical value but has its inherent limitations. In recent years, modifications of established (PET)/CT criteria have been proposed to provide more refined approaches towards response evaluation. Not only a comprehensive inclusion of PET-based response criteria in prospective randomized controlled trials, but also a general harmonization within the variety of PET-based response criteria is pertinent to strengthen clinical implementation and widespread use of hybrid imaging for response assessment in NSCLC.

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Title: PET/CT imaging for evaluation of multimodal treatment efficacy and toxicity in advanced NSCLC—current state and future directions
Authors: Chukwuka Eze
Nina-Sophie Schmidt-Hegemann
Lino Morris Sawicki
Julian Kirchner
Olarn Roengvoraphoj
Lukas Käsmann
Lena M. Mittlmeier
Wolfgang G. Kunz
Amanda Tufman
Julien Dinkel
Jens Ricke
Claus Belka
Farkhad Manapov
Marcus Unterrainer
Publication date: 01-11-2021
Publisher: Springer Berlin Heidelberg
Keywords: NSCLC
NSCLC
Checkpoint Inhibitors
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 12/2021
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-021-05211-8

At a glance: The STEP trials

Springer Medicine

PET/CT imaging for evaluation of multimodal treatment efficacy and toxicity in advanced NSCLC—current state and future directions

Abstract

Purpose

Methods

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Conclusions

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