Evidence map›Paper›PMID 38136348›Full record

ArticleCancers2023

Increased Thyroidal Activity on Routine FDG-PET/CT after Combination Immune Checkpoint Inhibition: Temporal Associations with Clinical and Biochemical Thyroiditis.

Anna Galligan, Roslyn Wallace, Balasubramanian Krishnamurthy, Thomas W H Kay, Nirupa Sachithanandan, Cherie Chiang, Shahneen Sandhu, Rodney J Hicks, Amir Iravani

Open access · goldAbstract read
In one paragraph

Article in Cancers, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
2.1field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 9 citations in OpenAlex.

  1. Baseline immune-organFrontiers in medicine · 2026
    Article
  2. Review
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  5. Article
  6. IsCancers · 2024
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 2 countries.

Anna GalliganDepartment of Endocrinology and Diabetes, St Vincent's Hospital Melbourne, Melbourne, VIC 3065, Australia.ORCID 0000-0003-4711-8180
Roslyn WallaceDepartment of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC 3052, Australia.
Balasubramanian KrishnamurthyDepartment of Endocrinology and Diabetes, St Vincent's Hospital Melbourne, Melbourne, VIC 3065, Australia.
Thomas W H KayDepartment of Endocrinology and Diabetes, St Vincent's Hospital Melbourne, Melbourne, VIC 3065, Australia.
Nirupa SachithanandanDepartment of Endocrinology and Diabetes, St Vincent's Hospital Melbourne, Melbourne, VIC 3065, Australia.ORCID 0000-0002-5074-0846
Cherie ChiangDepartment of Internal Medicine, Peter MacCallum Cancer Centre, Melbourne, VIC 3052, Australia.ORCID 0000-0002-9392-6771
Shahneen SandhuDepartment of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC 3052, Australia.ORCID 0000-0002-8660-4475
Rodney J HicksDepartment of Medicine, St Vincent's Hospital Medical School, University of Melbourne, Melbourne, VIC 3010, Australia.
Amir IravaniDepartment of Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, VIC 3000, Australia.ORCID 0000-0002-1273-5835
The University of Melbourne · AUPeter MacCallum Cancer Centre · AUThe Royal Melbourne Hospital · AUUniversity of Washington · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFDG-PET/CT used for immune checkpoint inhibitor (ICI) response assessment can incidentally identify immune-related adverse events (irAEs), including thyroiditis. This study aimed to correlate the time course of FDG-PET/CT evidence of thyroiditis with clinical and biochemical evolution of thyroid dysfunction.

methodsA retrospective review was performed by two independent blinded nuclear medicine physicians (NMPs) of thyroidal FDG uptake in 127 patients who underwent PET/CT between January 2016 and January 2019 at baseline and during treatment monitoring of combination ICI therapy for advanced melanoma. Interobserver agreement was assessed and FDG-PET/CT performance defined by a receiver-operating characteristic (ROC) curve using thyroid function tests (TFTs) as the standard of truth. Thyroid maximum standardized uptake value (SUVmax) and its temporal changes with respect to the longitudinal biochemistry were serially recorded.

resultsAt a median of 3 weeks after commencing ICI, 43/127 (34%) had a diagnosis of thyroiditis established by abnormal TFTs. FDG-PET/CT was performed at baseline and at a median of 11 weeks (range 3-32) following the start of therapy. ROC analysis showed an area under the curve of 0.87 (95% CI 0.80, 0.94) for FDG-PET/CT for detection of thyroiditis with a positive predictive value of 93%. Among patients with biochemical evidence of thyroiditis, those with a positive FDG-PET/CT were more likely to develop overt hypothyroidism (77% versus 35%,

conclusionIncreased metabolic activity of the thyroid on routine FDG-PET/CT performed for tumoral response of patients undergoing ICI therapy is generally detected well after routine biochemical diagnosis. Elevation of FDG uptake in the thyroid is predictive of overt clinical hypothyroidism and suggests that an ongoing robust inflammatory response beyond the initial thyrotoxic phase may be indicative of thyroid destruction.

Indexed as

combination immunotherapyendocrine toxicityFDG-PET/CTimmune-related adverse eventinterobserver agreementipilimumab and nivolumabmelanomathyroiditis

Identifiers

PMID38136348
PMCPMC10741830
OpenAlexW4389547142

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.