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Diagnostics (Basel). 2017 Apr 21;7(2). pii: E23. doi: 10.3390/diagnostics7020023.

Nuclear Molecular Imaging Strategies in Immune Checkpoint Inhibitor Therapy.

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Department of Pulmonary and Infectious Diseases, Nordsjællands Hospital Hillerød, 3400 Hillerød, Denmark.
Department of Clinical Physiology and Nuclear Medicine, Herlev and Gentofte Hospital, 2750 Herlev, Denmark.
Department of Oncology 5073, Rigshospitalet, 2100 Copenhagen, Denmark.
Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, 2100 Copenhagen, Denmark.


Immune checkpoint inhibitor therapy (ICT) is a new treatment strategy developed for the treatment of cancer. ICT inhibits pathways known to downregulate the innate immune response to cancer cells. These drugs have been shown to be effective in the treatment of a variety of cancers, including metastatic melanoma and lung cancer. Challenges in response evaluation of patients in ICT have risen as immune related side effects and immune cell infiltration may be confused with progressive disease. Furthermore, the timing of the evaluation scan may be challenged by relatively slow responses. To overcome this, new response criteria for evaluating these patients with morphologic imaging have been proposed. The aim of this paper is to review and discuss the current evidence for the use of molecular imaging, e.g., PET/CT (Positron Emission Tomography/Computer Tomography) with 18F-Fluorodeoxyglucoes (FDG) as an alternative imaging method for monitoring patients undergoing ICT. Following the currently available evidence, this review will primarily focus on patients with malignant melanoma.


PET/CT; immune checkpoint inhibitor therapy; radiotracer; response evaluation/treatment monitoring

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