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Review
. 2023 Nov;30(11):2712-2727.
doi: 10.1016/j.acra.2023.04.004. Epub 2023 Jun 30.

Imaging the Side Effects of CAR T Cell Therapy: A Primer for the Practicing Radiologist

Sophia Huang  1 , Dorine de Jong  2 , Jeeban P Das  3 , Reginald Scott Widemon  1 , Brian Braumuller  1 , Jacienta Paily  1 , Aileen Deng  4 , Connie Liou  1 , Tina Roa  1 , Alice Huang  1 , Hong Ma  1 , Belinda D'Souza  1 , Jay Leb  1 , Jade L'Hereaux  1 , Pamela Nguyen  1 , Lyndon Luk  1 , Mark Francescone  1 , Randy Yeh  3 , Valerie Maccarrone  1 , Laurent Dercle  1 , Mary M Salvatore  1 , Kathleen M Capaccione  5
Affiliations
Review

Imaging the Side Effects of CAR T Cell Therapy: A Primer for the Practicing Radiologist

Sophia Huang et al. Acad Radiol. 2023 Nov.

Abstract

Chimeric antigen receptor (CAR) T cell therapy is a revolutionary form of immunotherapy that has proven to be efficacious in the treatment of many hematologic cancers. CARs are modified T lymphocytes that express an artificial receptor specific to a tumor-associated antigen. These engineered cells are then reintroduced to upregulate the host immune responses and eradicate malignant cells. While the use of CAR T cell therapy is rapidly expanding, little is known about how common side effects such as cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity (ICANS) present radiographically. Here we provide a comprehensive review of how side effects present in different organ systems and how they can be optimally imaged. Early and accurate recognition of the radiographic presentation of these side effects is critical to the practicing radiologist and their patients so that these side effects can be promptly identified and treated.

Keywords: CAR T cell therapy; adverse events; imaging; immunology.

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Conflict of interest statement

Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Kathleen M. Capaccione reports a relationship with Cardinal Health that includes: consulting or advisory. Mary Salvatore reports a relationship with Genentech and Boehringer Ingelheim that includes: consulting or advisory, funding/grants, and speaking and lecture fees.

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