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@ARTICLE{Anwar:132432,
      author       = {H. Anwar$^*$ and C. Sachpekidis$^*$ and J. Winkler and A.
                      Kopp-Schneider$^*$ and U. Haberkorn$^*$ and J. C. Hassel and
                      A. Dimitrakopoulou-Strauss$^*$},
      title        = {{A}bsolute number of new lesions on18{F}-{FDG} {PET}/{CT}
                      is more predictive of clinical response than {SUV} changes
                      in metastatic melanoma patients receiving ipilimumab.},
      journal      = {European journal of nuclear medicine and molecular imaging},
      volume       = {45},
      number       = {3},
      issn         = {1619-7089},
      address      = {Heidelberg [u.a.]},
      publisher    = {Springer-Verl.},
      reportid     = {DKFZ-2018-00120},
      pages        = {376 - 383},
      year         = {2018},
      abstract     = {Evaluation of response to immunotherapy is a matter of
                      debate. The aim of the present study was to evaluate the
                      response of metastatic melanoma to treatment with ipilimumab
                      by means of18F-FDG PET/CT, using the patients' clinical
                      response as reference.The final cohort included in the
                      analyses consisted of 41 patients with metastatic melanoma
                      who underwent18F-FDG PET/CT before and after administration
                      of ipilimumab. After determination of the best clinical
                      response, the PET/CT scans were reviewed and a separate
                      independent analysis was performed, based on the number and
                      functional size of newly emerged18F-FDG-avid lesions, as
                      well as on the SUV changes after therapy.The median
                      observation time of the patients after therapy was
                      21.4 months (range 6.3-41.9 months). Based on their
                      clinical response, patients were dichotomized into those
                      with clinical benefit (CB) and those without CB (No-CB). The
                      CB group (31 patients) included those with stable disease,
                      partial remission and complete remission, and the No-CB
                      group (10 patients) included those with progressive disease.
                      The application of a threshold of four newly
                      emerged18F-FDG-avid lesions on the posttherapy PET/CT scan
                      led to a sensitivity (correctly predicting CB) of $84\%$ and
                      a specificity (correctly predicting No-CB) of $100\%.$ This
                      cut-off was lower for lesions with larger functional
                      diameters (three new lesions larger than 1.0 cm and two new
                      lesions larger than 1.5 cm). SUV changes after therapy did
                      not correlate with clinical response. Based on these
                      findings, we developed criteria for predicting clinical
                      response to immunotherapy by means of18F-FDG PET/CT (PET
                      Response Evaluation Criteria for Immunotherapy, PERCIMT).Our
                      results show that a cut-off of four newly
                      emerged18F-FDG-avid lesions on posttherapy PET/CT gives a
                      reliable indication of treatment failure in patients under
                      ipilimumab treatment. Moreover, the functional size of the
                      new lesions plays an important role in predicting the
                      clinical response. Validation of these results in larger
                      cohorts of patients is warranted.},
      cin          = {E060 / C060},
      ddc          = {610},
      cid          = {I:(DE-He78)E060-20160331 / I:(DE-He78)C060-20160331},
      pnm          = {315 - Imaging and radiooncology (POF3-315)},
      pid          = {G:(DE-HGF)POF3-315},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:29124281},
      doi          = {10.1007/s00259-017-3870-6},
      url          = {https://inrepo02.dkfz.de/record/132432},
}