التفاصيل البيبلوغرافية
| العنوان: |
Imaging for assessment of cancer treatment response to immune checkpoint inhibitors can be complementary in identifying hypophysitis. |
| المؤلفون: |
Galligan, Anna, Iravani, Amir, Lasocki, Arian, Wallace, Roslyn, Weppler, Alison M., Sachithanandan, Nirupa, Chiang, Cherie, Colman, Peter G., Wentworth, John, Spain, Lavinia, Au-Yeung, George, Lee, Belinda, Kay, Thomas W. H., Hicks, Rodney J., Sandhu, Shahneen, Krishnamurthy, Balasubramanian |
| المصدر: |
Frontiers in Endocrinology; 2023, p1-10, 10p |
| مصطلحات موضوعية: |
POSITRON emission tomography computed tomography, IMMUNE checkpoint inhibitors, MAGNETIC resonance imaging, CANCER treatment, GLANDS, IMMUNE response, PITUITARY gland |
| مستخلص: |
Introduction: Hypophysitis is reported in 8.5%-14% of patients receiving combination immune checkpoint inhibition (cICI) but can be a diagnostic challenge. This study aimed to assess the role of routine diagnostic imaging performed during therapeutic monitoring of combination anti-CTLA-4/anti-PD-1 treatment in the identification of hypophysitis and the relationship of imaging findings to clinical diagnostic criteria. Methods: This retrospective cohort study identified patients treated with cICI between January 2016 and January 2019 at a quaternary melanoma service. Medical records were reviewed to identify patients with a documented diagnosis of hypophysitis based on clinical criteria. Available structural brain imaging with magnetic resonance imaging (MRI) or computed tomography (CT) of the brain and 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography with computed tomography (FDG-PET/CT) were assessed retrospectively. The main radiological outcome measures were a relative change in pituitary size or FDG uptake temporally attributed to cICI. Results: There were 162 patients (median age 60 years, 30% female) included. A total of 100 and 134 had serial CT/MRI of the brain and FDG-PET/CT, respectively. There were 31 patients who had a documented diagnosis of hypophysitis and an additional 20 who had isolated pituitary imaging findings. The pituitary gland enlargement was mild, and the largest absolute gland size was 13 mm, with a relative increase of 7 mm from baseline. There were no cases of optic chiasm compression. Pituitary enlargement and increased FDG uptake were universally transient. High-dose glucocorticoid treatment for concurrent irAEs prevented assessment of the pituitary-adrenal axis in 90% of patients with isolated imaging findings. Conclusion: Careful review of changes in pituitary characteristics on imaging performed for assessment of therapeutic response to iICI may lead to increased identification and more prompt management of cICI-induced hypophysitis. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
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