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Clinical/methodical issue <p>Distinguishing pseudoprogression from true progression represents a&#xa0;considerable challenge in both clinical practice and radiological imaging.</p> Standard radiological methods <p>Established radiological methods include computed tomography (CT) and magnetic resonance imaging (MRI), complemented by fluorodeoxyglucose-positron emission tomography (FDG-PET)/CT from nuclear medicine.</p> Methodical innovations <p>Novel PET/CT tracers, liquid biopsies, and radiomics are considered innovative approaches that may facilitate the detection of pseudoprogression but still need clinical validation.</p> Performance <p>CT, MRI, and PET/CT can provide valuable clues for distinguishing pseudoprogression from true progression, but are often inconclusive. Novel imaging approaches are currently under investigation in clinical studies.</p> Achievements <p>The use of laboratory markers and radiomics has shown promising improvements in several studies, but has not yet been adopted into clinical routine.</p> Practical recommendations <p>In clinically stable patients, suspected pseudoprogression early after start of immunotherapy justifies continuation of therapy with close imaging follow-up (early follow-up after 4–8&#xa0;weeks).</p>

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Pseudoprogression bei Immuntherapien

  • 期刊论文

  • 发表日期：

    2025年12月9日

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  • Michael Winkelmann,
  • Matthias Kassube,
  • Philipp Linden,
  • Johannes Rübenthaler,
  • Gabriel T. Sheikh,
  • Wolfgang G. Kunz

摘要

Clinical/methodical issue

Distinguishing pseudoprogression from true progression represents a considerable challenge in both clinical practice and radiological imaging.

Standard radiological methods

Established radiological methods include computed tomography (CT) and magnetic resonance imaging (MRI), complemented by fluorodeoxyglucose-positron emission tomography (FDG-PET)/CT from nuclear medicine.

Methodical innovations

Novel PET/CT tracers, liquid biopsies, and radiomics are considered innovative approaches that may facilitate the detection of pseudoprogression but still need clinical validation.

Performance

CT, MRI, and PET/CT can provide valuable clues for distinguishing pseudoprogression from true progression, but are often inconclusive. Novel imaging approaches are currently under investigation in clinical studies.

Achievements

The use of laboratory markers and radiomics has shown promising improvements in several studies, but has not yet been adopted into clinical routine.

Practical recommendations

In clinically stable patients, suspected pseudoprogression early after start of immunotherapy justifies continuation of therapy with close imaging follow-up (early follow-up after 4–8 weeks).