% IMPORTANT: The following is UTF-8 encoded. This means that in the presence % of non-ASCII characters, it will not work with BibTeX 0.99 or older. % Instead, you should use an up-to-date BibTeX implementation like “bibtex8” or % “biber”. @ARTICLE{Sachpekidis:304463, author = {C. Sachpekidis$^*$ and D. Machiraju and D. S. Strauss and L. Pan$^*$ and A. Kopp-Schneider$^*$ and L. Edenbrandt and A. Dimitrakopoulou-Strauss$^*$ and J. C. Hassel}, title = {{A}rtificial intelligence-assisted assessment of metabolic response to tebentafusp in metastatic uveal melanoma: a long axial field-of-view [18{F}]{FDG} {PET}/{CT} study.}, journal = {European journal of nuclear medicine and molecular imaging}, volume = {nn}, issn = {1619-7070}, address = {Heidelberg [u.a.]}, publisher = {Springer-Verl.}, reportid = {DKFZ-2025-01856}, pages = {nn}, year = {2025}, note = {#EA:E060#LA:E060# / epub}, abstract = {Tebentafusp has emerged as the first systemic therapy to significantly prolong survival in treatment-naïve HLA-A*02:01 + patients with unresectable or metastatic uveal melanoma (mUM). Notably, a survival benefit has been observed even in the absence of radiographic response. This study aims to investigate the feasibility and prognostic value of artificial intelligence (AI)-assisted quantification and metabolic response assessment of [18F]FDG long axial field-of-view (LAFOV) PET/CT in mUM patients undergoing tebentafusp therapy.Fifteen patients with mUM treated with tebentafusp underwent [18F]FDG LAFOV PET/CT at baseline and 3 months post-treatment. Total metabolic tumor volume (TMTV) and total lesion glycolysis (TLG) were quantified using a deep learning-based segmentation tool On the RECOMIA platform. Metabolic response was assessed according to AI-assisted PERCIST 1.0 criteria. Associations between PET-derived parameters and overall survival (OS) were evaluated using Kaplan-Meier survival analysis.The median follow up $(95\%$ CI) was 14.1 months (12.9 months - not available). Automated TMTV and TLG measurements were successfully obtained in all patients. Elevated baseline TMTV and TLG were significantly associated with shorter OS (TMTV: 16.9 vs. 27.2 months; TLG: 16.9 vs. 27.2 months; p < 0.05). Similarly, higher TMTV and TLG at 3 months post-treatment predicted poorer survival outcomes (TMTV: 14.3 vs. 24.5 months; TLG: 14.3 vs. 24.5 months; p < 0.05). AI-assisted PERCIST response evaluation identified six patients with disease control (complete metabolic response, partial metabolic response, stable metabolic disease) and nine with progressive metabolic disease. A trend toward improved OS was observed in patients with disease control (24.5 vs. 14.6 months, p = 0.08). Circulating tumor DNA (ctDNA) levels based on GNAQ and GNA11 mutations were available in 8 patients; after 3 months Of tebentafusp treatment, 5 showed reduced Or stable ctDNA levels, and 3 showed an increase (median OS: 24.5 vs. 3.3 months; p = 0.13). Patients with increasing ctDNA levels exhibited significantly higher TMTV and TLG on follow-up imaging.AI-assisted whole-body quantification of [1⁸F]FDG PET/CT and PERCIST-based response assessment are feasible and hold prognostic significance in tebentafusp-treated mUM. TMTV and TLG may serve as non-invasive imaging biomarkers for risk stratification and treatment monitoring in this malignancy.}, keywords = {Artificial intelligence (Other) / CtDNA (Other) / Deep learning (Other) / Metastatic uveal melanoma (Other) / PERCIST (Other) / Tebentafusp (Other) / Total lesion glycolysis (TLG) (Other) / Total metabolic tumor volume (TMTV) (Other) / Treatment response evaluation (Other) / [18F]FDG LAFOV PET/CT (Other)}, cin = {E060 / C060}, ddc = {610}, cid = {I:(DE-He78)E060-20160331 / I:(DE-He78)C060-20160331}, pnm = {315 - Bildgebung und Radioonkologie (POF4-315)}, pid = {G:(DE-HGF)POF4-315}, typ = {PUB:(DE-HGF)16}, pubmed = {pmid:40913640}, doi = {10.1007/s00259-025-07504-8}, url = {https://inrepo02.dkfz.de/record/304463}, }