Theranostics 2019; 9(17):5085-5104. doi:10.7150/thno.34415

Review

Current and Future Imaging Methods for Evaluating Response to Immunotherapy in Neuro-Oncology

Benjamin B. Kasten1, Neha Udayakumar2, Jianmei W. Leavenworth1, Anna M. Wu3, Suzanne E. Lapi4, Jonathan E. McConathy4, Anna G. Sorace4, Asim K. Bag5, James M. Markert1, Jason M. Warram6✉

1. Department of Neurosurgery, University of Alabama at Birmingham, Birmingham, AL, United States.
2. School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States.
3. Crump Institute for Molecular Imaging, Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, United States.
4. Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, United States.
5. Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, TN, United States.
6. Department of Otolaryngology, University of Alabama at Birmingham, Birmingham, AL, United States.

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Citation:
Kasten BB, Udayakumar N, Leavenworth JW, Wu AM, Lapi SE, McConathy JE, Sorace AG, Bag AK, Markert JM, Warram JM. Current and Future Imaging Methods for Evaluating Response to Immunotherapy in Neuro-Oncology. Theranostics 2019; 9(17):5085-5104. doi:10.7150/thno.34415. Available from https://www.thno.org/v09p5085.htm

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Abstract

Imaging plays a central role in evaluating responses to therapy in neuro-oncology patients. The advancing clinical use of immunotherapies has demonstrated that treatment-related inflammatory responses mimic tumor growth via conventional imaging, thus spurring the development of new imaging approaches to adequately distinguish between pseudoprogression and progressive disease. To this end, an increasing number of advanced imaging techniques are being evaluated in preclinical and clinical studies. These novel molecular imaging approaches will serve to complement conventional response assessments during immunotherapy. The goal of these techniques is to provide definitive metrics of tumor response at earlier time points to inform treatment decisions, which has the potential to improve patient outcomes. This review summarizes the available immunotherapy regimens, clinical response criteria, current state-of-the-art imaging approaches, and groundbreaking strategies for future implementation to evaluate the anti-tumor and immune responses to immunotherapy in neuro-oncology applications.

Keywords: neuro-oncology, immunotherapy, imaging, response, MRI, PET