Complex Immunotherapy-mediated Response Patterns Depicted on Serial 18F-FDG PET imaging of Hodgkin Lymphoma Patient Undergoing Pembrolizumab Therapy
Over the past decade, the role of 18F-Fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) in assessing treatment response for lymphoma patients undergoing immunotherapy has been extensively investigated. The advent of immunotherapy has challenged the utility of the...
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Mashhad University of Medical Sciences
2025-07-01
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| Series: | Asia Oceania Journal of Nuclear Medicine and Biology |
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| Online Access: | https://aojnmb.mums.ac.ir/article_25943_d75fe98ed83c58462cb6fbc2242352a3.pdf |
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| author | Mohanad Badarneh Ahmed Abdlkadir Mohammad Makoseh Alaa Abufara Akram Al-Ibraheem |
| author_facet | Mohanad Badarneh Ahmed Abdlkadir Mohammad Makoseh Alaa Abufara Akram Al-Ibraheem |
| author_sort | Mohanad Badarneh |
| collection | DOAJ |
| description | Over the past decade, the role of 18F-Fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) in assessing treatment response for lymphoma patients undergoing immunotherapy has been extensively investigated. The advent of immunotherapy has challenged the utility of the established Lugano criteria, prompting the development of novel immunotherapy-specific response criteria now employed in clinical practice. Following 18F-FDG PET/CT evaluation after up to eight immunotherapy cycles, patients are typically transitioned to conventional imaging modalities if immunotherapy continuation is warranted. This case report illustrates the application of serial 18F-FDG PET/CT in monitoring a 67-year-old patient with Hodgkin lymphoma receiving immunotherapy, revealing complex, atypical response patterns unresolved by existing criteria. Notably, two episodes of pseudoprogression occurred at two distinct time points, one during cycle 5 and the other during cycle 22. Furthermore, an immunotherapy-enhanced abscopal effect was seen during radio-immunotherapy, leading to short-term disease remission. Our findings suggest that 18F-FDG PET/CT provides superior predictive value in delineating heterogeneous response patterns, thereby informing critical decisions regarding immunotherapy cessation or adjunctive therapeutic interventions. |
| format | Article |
| id | doaj-art-ec09ace5b7d14a4ba5572bee2b135b95 |
| institution | Kabale University |
| issn | 2322-5718 2322-5726 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Mashhad University of Medical Sciences |
| record_format | Article |
| series | Asia Oceania Journal of Nuclear Medicine and Biology |
| spelling | doaj-art-ec09ace5b7d14a4ba5572bee2b135b952025-08-20T03:24:08ZengMashhad University of Medical SciencesAsia Oceania Journal of Nuclear Medicine and Biology2322-57182322-57262025-07-0113218518910.22038/aojnmb.2025.86889.162125943Complex Immunotherapy-mediated Response Patterns Depicted on Serial 18F-FDG PET imaging of Hodgkin Lymphoma Patient Undergoing Pembrolizumab TherapyMohanad Badarneh0Ahmed Abdlkadir1Mohammad Makoseh2Alaa Abufara3Akram Al-Ibraheem4Department of Nuclear Medicine, King Hussein Cancer Center (KHCC), Amman, JordanDepartment of Nuclear Medicine, King Hussein Cancer Center (KHCC), Amman, JordanDepartment of Medicine, King Hussein Cancer Center (KHCC), Amman, JordanDepartment of Medicine, King Hussein Cancer Center (KHCC), Amman, JordanDepartment of Nuclear Medicine, King Hussein Cancer Center (KHCC), Amman, JordanOver the past decade, the role of 18F-Fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) in assessing treatment response for lymphoma patients undergoing immunotherapy has been extensively investigated. The advent of immunotherapy has challenged the utility of the established Lugano criteria, prompting the development of novel immunotherapy-specific response criteria now employed in clinical practice. Following 18F-FDG PET/CT evaluation after up to eight immunotherapy cycles, patients are typically transitioned to conventional imaging modalities if immunotherapy continuation is warranted. This case report illustrates the application of serial 18F-FDG PET/CT in monitoring a 67-year-old patient with Hodgkin lymphoma receiving immunotherapy, revealing complex, atypical response patterns unresolved by existing criteria. Notably, two episodes of pseudoprogression occurred at two distinct time points, one during cycle 5 and the other during cycle 22. Furthermore, an immunotherapy-enhanced abscopal effect was seen during radio-immunotherapy, leading to short-term disease remission. Our findings suggest that 18F-FDG PET/CT provides superior predictive value in delineating heterogeneous response patterns, thereby informing critical decisions regarding immunotherapy cessation or adjunctive therapeutic interventions.https://aojnmb.mums.ac.ir/article_25943_d75fe98ed83c58462cb6fbc2242352a3.pdfpet/ct18f-fdgimmunotherapyabscopal effectpseudoprogression |
| spellingShingle | Mohanad Badarneh Ahmed Abdlkadir Mohammad Makoseh Alaa Abufara Akram Al-Ibraheem Complex Immunotherapy-mediated Response Patterns Depicted on Serial 18F-FDG PET imaging of Hodgkin Lymphoma Patient Undergoing Pembrolizumab Therapy Asia Oceania Journal of Nuclear Medicine and Biology pet/ct 18f-fdg immunotherapy abscopal effect pseudoprogression |
| title | Complex Immunotherapy-mediated Response Patterns Depicted on Serial 18F-FDG PET imaging of Hodgkin Lymphoma Patient Undergoing Pembrolizumab Therapy |
| title_full | Complex Immunotherapy-mediated Response Patterns Depicted on Serial 18F-FDG PET imaging of Hodgkin Lymphoma Patient Undergoing Pembrolizumab Therapy |
| title_fullStr | Complex Immunotherapy-mediated Response Patterns Depicted on Serial 18F-FDG PET imaging of Hodgkin Lymphoma Patient Undergoing Pembrolizumab Therapy |
| title_full_unstemmed | Complex Immunotherapy-mediated Response Patterns Depicted on Serial 18F-FDG PET imaging of Hodgkin Lymphoma Patient Undergoing Pembrolizumab Therapy |
| title_short | Complex Immunotherapy-mediated Response Patterns Depicted on Serial 18F-FDG PET imaging of Hodgkin Lymphoma Patient Undergoing Pembrolizumab Therapy |
| title_sort | complex immunotherapy mediated response patterns depicted on serial 18f fdg pet imaging of hodgkin lymphoma patient undergoing pembrolizumab therapy |
| topic | pet/ct 18f-fdg immunotherapy abscopal effect pseudoprogression |
| url | https://aojnmb.mums.ac.ir/article_25943_d75fe98ed83c58462cb6fbc2242352a3.pdf |
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