PMID- 37310248
OWN - NLM
STAT- MEDLINE
DCOM- 20230615
LR  - 20230620
IS  - 1527-1315 (Electronic)
IS  - 0033-8419 (Linking)
VI  - 307
IP  - 5
DP  - 2023 Jun
TI  - Chimeric Antigen Receptor T-Cell Therapy and Imaging Applications for Large 
      B-Cell Lymphoma.
PG  - e221362
LID - 10.1148/radiol.221362 [doi]
AB  - Chimeric antigen receptor (CAR) T-cell therapy has revolutionized the treatment 
      of large B-cell lymphoma (LBCL) and other hematologic malignancies. Its mechanism 
      of action relies on recent biotechnological advances that allow clinicians to 
      harness and enhance a patient's immune system to fight cancerous cells. The 
      indications for CAR T-cell therapy continue to expand, with ongoing trials 
      evaluating their use in other hematologic and solid organ malignancies. This 
      review explores the vital role of diagnostic imaging in patient selection and 
      treatment response in CAR T-cell therapy for LBCL and the management of specific 
      therapy-related adverse events. For a patient-centered and cost-effective use of 
      CAR T-cell therapy, it is crucial to select patients who are likely to derive 
      long-term benefit and optimize their care during a lengthy treatment pathway. 
      Metabolic tumor volume and kinetics assessed at PET/CT have emerged as powerful 
      tools to predict outcome after CAR T-cell therapy in LBCL, allowing for the early 
      identification of lesions refractory to treatment and identification of the 
      severity of CAR T-cell therapy toxicity. Radiologists should be aware that the 
      success of CAR T-cell therapy is mitigated by adverse events, most importantly 
      neurotoxicity, which remains poorly understood and challenging to treat. 
      Neuroimaging, with experienced clinical evaluation, is critical in the diagnosis 
      and management of neurotoxicity and the exclusion of other central nervous system 
      complications that can occur in this clinically vulnerable patient group. This 
      review discusses current applications of imaging in the standard CAR T-cell 
      therapy pathway for the treatment of LBCL, which serves as a model disease in the 
      integration of diagnostic imaging and radiomic risk markers.
CI  - (c) RSNA, 2023.
FAU - Mulholland, Nicola
AU  - Mulholland N
AD  - From the Departments of Radiology (N.M., J.C.) and Hematology (R.S., A.K.), 
      King's College Hospital NHS Foundation Trust, Denmark Hill, London SE5 9RS, 
      United Kingdom.
FAU - Chandra, Julie
AU  - Chandra J
AUID- ORCID: 0000-0002-7904-6188
AD  - From the Departments of Radiology (N.M., J.C.) and Hematology (R.S., A.K.), 
      King's College Hospital NHS Foundation Trust, Denmark Hill, London SE5 9RS, 
      United Kingdom.
FAU - Sanderson, Robin
AU  - Sanderson R
AUID- ORCID: 0000-0003-4915-2833
AD  - From the Departments of Radiology (N.M., J.C.) and Hematology (R.S., A.K.), 
      King's College Hospital NHS Foundation Trust, Denmark Hill, London SE5 9RS, 
      United Kingdom.
FAU - Kuhnl, Andrea
AU  - Kuhnl A
AUID- ORCID: 0000-0002-4952-2550
AD  - From the Departments of Radiology (N.M., J.C.) and Hematology (R.S., A.K.), 
      King's College Hospital NHS Foundation Trust, Denmark Hill, London SE5 9RS, 
      United Kingdom.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Radiology
JT  - Radiology
JID - 0401260
RN  - 0 (Receptors, Chimeric Antigen)
SB  - IM
MH  - Humans
MH  - *Receptors, Chimeric Antigen/therapeutic use
MH  - Immunotherapy, Adoptive
MH  - Positron Emission Tomography Computed Tomography
MH  - *Lymphoma, Large B-Cell, Diffuse
MH  - *Neurotoxicity Syndromes
MH  - Cell- and Tissue-Based Therapy
EDAT- 2023/06/13 13:12
MHDA- 2023/06/15 06:42
CRDT- 2023/06/13 10:05
PHST- 2023/06/15 06:42 [medline]
PHST- 2023/06/13 13:12 [pubmed]
PHST- 2023/06/13 10:05 [entrez]
AID - 10.1148/radiol.221362 [doi]
PST - ppublish
SO  - Radiology. 2023 Jun;307(5):e221362. doi: 10.1148/radiol.221362.