Imaging Features of Pulmonary Immune-related Adverse Events

Chiara Pozzessere; Romain Lazor; Raphael Jumeau; Solange Peters; John O Prior; Catherine Beigelman-Aubry

doi:10.1016/j.jtho.2021.05.017

Imaging Features of Pulmonary Immune-related Adverse Events

J Thorac Oncol. 2021 Sep;16(9):1449-1460. doi: 10.1016/j.jtho.2021.05.017. Epub 2021 Jun 1.

Authors

Chiara Pozzessere¹, Romain Lazor², Raphael Jumeau³, Solange Peters⁴, John O Prior⁵, Catherine Beigelman-Aubry⁶

Affiliations

¹ Department of Radiology, AUSL Toscana Centro, San Giuseppe Hospital, Empoli, Italy; Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland. Electronic address: chiara.pozzessere@gmail.com.
² Respiratory Medicine Department, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland.
³ Department of Radiation Oncology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland.
⁴ Medical Oncology Department, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland.
⁵ Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland.
⁶ Department of Radiodiagnostic and Interventional Radiology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland.

PMID: 34087477
DOI: 10.1016/j.jtho.2021.05.017

Abstract

Pulmonary immune-related adverse events represent rare but potentially severe side effects of immunotherapies. Diagnosis is often challenging, as symptoms and imaging features are not specific and may mimic other lung diseases, thus potentially delaying appropriate patient management. In this setting, an accurate imaging evaluation is essential for a prompt detection and correct management of these drug-induced lung diseases. The purpose of this article is to review the different types of pulmonary immune-related adverse events, describe their imaging characteristics on both high-resolution computed tomography and positron emission tomography/computed tomography and stress their underlying diagnostic challenge by presenting the mimickers.

Keywords: CTLA-4 antigen; Drug-related side effects and adverse reactions; Immunotherapy; Pneumonitis; Programmed cell death 1 receptor.

Publication types

Review

MeSH terms

CTLA-4 Antigen
Humans
Immunotherapy
Lung
Lung Neoplasms* / diagnostic imaging
Programmed Cell Death 1 Receptor*

Substances

CTLA-4 Antigen
Programmed Cell Death 1 Receptor