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E2310. Immunotherapy-Related Adverse Events: Appearance on 18F-FDG PET/CT
Authors
  1. Mark Ehrhart; University of New Mexico Health Sciences Center
  2. Nandan Keshav; University of New Mexico Health Sciences Center
  3. Jonathan Revels; University of New Mexico Health Sciences Center
  4. Shana Elman; University of New Mexico Health Sciences Center
Background
Immune-modulating drugs, particularly immune-checkpoint inhibitors, have become standard of care in melanoma, lung cancer, and renal cell cancer, with increasing scope of use in other malignancies, such as head & neck cancers and gynecologic malignancies. Despite the overall survival benefit shown with these therapies, there are many immunotherapy-related adverse events (irAEs), which can often be detected on imaging. Prompt identification of irAEs on imaging allows the treating clinicians to initiate appropriate treatment for the adverse events and/or modify immunotherapy, sometimes even before the patient experiences symptoms. Understanding the imaging appearance is also important to prevent misinterpretation of findings as disease progression.

Educational Goals / Teaching Points
Increasing use of immunotherapy in oncology necessitates an understanding of immunotherapy-related adverse events (irAEs). Oncologic imagers can play an essential role in early identification of irAEs, sometimes even before symptom onset, resulting in prompt treatment of these adverse events or other necessary modifications to the treatment regimen. This educational exhibit familiarizes the participant with typical imaging appearances of irAEs on F-18 FDG PET/CT, including pneumonitis, colitis, thyroiditis, autoimmune hypophysitis, pancreatitis, polyarthralgia, and rash.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Case examples of F-18 FDG PET/CT in patients on immunotherapy will be used to demonstrate the imaging appearances of irAEs, including pneumonitis, colitis, thyroiditis, autoimmune hypophysitis, pancreatitis, polyarthralgia, and rash.

Conclusion
F-18 FDG PET/CT is commonly used in the monitoring of treatment response to immunotherapy, which is increasingly used in oncology. Familiarization with the common imaging appearance of immunotherapy-related adverse events can lead to early identification of irAEs, sometimes even before symptom onset, resulting in prompt treatment of these adverse events or other necessary modifications to the treatment regimen.