Evidence map›Paper›PMID 39873753›Full record

ArticleEuropean radiology2025

Dual-energy CT iodine concentration as a biomarker for immunotherapy treatment response in metastatic melanoma and renal cell carcinoma patients.

Natalie Wiley, Mladen Zecevic, Vivian Ho, Matthew J Stolzberg, Danielle Cox, Erik V Soloff, Evan Hall, Carolyn L Wang

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Article in European radiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
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

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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

8 citing papers in PubMed.

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4 · The record

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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

8 authors.

Natalie WileyDepartment of Radiology, University of Washington, Seattle, WA, USA.
Mladen ZecevicDepartment of Radiology, University of Washington, Seattle, WA, USA.
Vivian HoDepartment of Radiology, University of Washington, Seattle, WA, USA.
Matthew J StolzbergDepartment of Radiology, University of Washington, Seattle, WA, USA.
Danielle CoxDepartment of Radiology, University of Washington, Seattle, WA, USA.
Erik V SoloffDepartment of Radiology, University of Washington, Seattle, WA, USA.
Evan HallDivision of Hematology and Oncology, University of Washington, Seattle, WA, USA.
Carolyn L WangDepartment of Radiology, University of Washington, Seattle, WA, USA. wangcl@uw.edu.ORCID http://orcid.org/0000-0002-0777-7272

Funding

GE Global Research A-71 AM003
6 · The paper itself

Abstract

objectiveTo investigate the predictive value of tumor iodine concentration obtained with dual-energy CT (DECT) for treatment response in patients treated with immune checkpoint inhibitors (ICI). MATERIALS AND

methodsRetrospective single-center study of consecutive metastatic melanoma and renal cell carcinoma (RCC) patients undergoing first-line ICI treatment. The iodine concentration measurement time points include prior to initiation of therapy (baseline [BL]), after initiation (follow-up [FU1]), and either time point nearest to 12 months or at time of progression (final follow-up [FFU]). Target lesion DECT-based whole-volume tumor normalized iodine concentration average (NICave) and size measurements were obtained. Reference standard was individual lesion FFU status categorized as responders or nonresponders per RECIST 1.1. Logistic regression model assessed NICave change and FU1 lesion response as predictors of FFU lesion outcome. Model's performance was summarized with AUC. Intraclass correlation coefficient (ICC) summarized inter-rater agreement of NICave.

resultsForty-six patients were included (mean age 61 ± 11 years, 12 women; 16 melanoma). Sixty-four of 175 target lesions were confirmed nonresponders at FFU. In a multivariable model, lesion status at FU1 (odds ratio [OR]: 27.4, p < 0.001) and changes in NICave from BL to FU1 (OR: 2.42 per 1-SD increase, p = 0.019) were significant predictors of lesion status at FFU. The model's AUC was 0.86 (95% CI: 0.76-0.93). Inter-rater reliability of NICave was 0.98 (95% CI: 0.97-0.99).

conclusionsChanges in iodine concentration from baseline to first follow-up improve identification of delayed responding metastatic melanoma and RCC lesions treated with immune checkpoint inhibitor, initially classified as nonresponders by size change. KEY POINTS: Question How can pseudoprogression/delayed treatment response in metastatic renal cell carcinoma (RCC) and melanoma patients on first-line immune checkpoint inhibitors be accurately identified? Findings Combining iodine concentration change from Dual-energy CT (baseline to first follow-up) with RECIST-based lesion size change improved prediction of final lesion outcome. Clinical relevance DECT-based whole-volume tumor iodine concentration for target lesions is useful as a predictive imaging biomarker for distinguishing delayed response from true progression in patients with metastatic RCC and melanoma treated with first-line immune checkpoint inhibitors.

Indexed as

Carcinoma, Renal CellImmune Checkpoint InhibitorsImmunotherapyIodineKidney NeoplasmsMelanomaTomography, X-Ray ComputedAgedContrast MediaFemaleHumansMaleMiddle AgedRetrospective StudiesTreatment OutcomeContrast MediaImmune Checkpoint InhibitorsIodineBiomarkerDual-energy computed tomographyImmunotherapyIodine concentrationResponse Evaluation Criteria in Solid Tumors

Identifiers

PMID39873753

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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.