PET-CT radiomics for immunotherapy response.

[INTRODUCTION] The aim of this review is to provide a comprehensive synthesis of the current literature on the use of PET radiomics for predicting response to immunotherapy in cancer patients, as well as to discuss the main challenges emerging from data analysis and propose potential directions for its broader integration into clinical practice.

[MATERIALS AND METHODS] papers regarding the use of radiomics and immunotherapy by using PET/CT were selected. Some criteria were used for the selection, such as five years from the date of publication and 2) inclusion of several patients (more than 100).

[RESULTS] Totally 24 papers were selected by using the following criteria. Most studies (N = 18/24; 75%) were related to the utility of radiomics for predicting immunotherapy in patients affected by lung cancer. In this setting, radiomics was able to predict the expression of PDL-1, with an important effect on the invasive procedures. In four studies, radiomics was used for predicting the prediction of response to CAR-T in patients affected by lymphoma. Emerging results are now available in patients with colon-rectal tumors and endometrial cancers, although with still limited evidence.

[CONCLUSIONS] radiomics holds substantial potential for characterizing the tumor immune microenvironment and predicting response to immunotherapy, especially in lung cancer and lymphoma.