基于嵌合抗原受体 (CAR)-T 细胞的免疫疗法已成为治疗某些血液恶性肿瘤的突破性策略。使用正电子发射断层扫描/计算机断层扫描 (PET/CT) 等定量成像技术评估 CAR-T 疗法的反应已得到广泛研究。然而，PET/CT 在 CAR-T 治疗中的明确作用仍有待确定。 [18F]FDG PET/CT 对于区分淋巴瘤 CAR-T 治疗后部分和完全缓解的患者具有高敏感性和特异性。早期治疗反应和免疫相关的不良反应，如细胞因子释放综合征和免疫效应细胞相关的神经毒性综合征也可以在[18F]FDG PET图像上检测到。在 CAR-T 治疗后部分缓解的无症状淋巴瘤患者中，唯一的阳性结果可能是异常的 PET/CT 结果。在多发性骨髓瘤中，接受 B 细胞成熟抗原导向的 CAR-T 治疗后 [18F]FDG PET/CT 阴性与良好的预后相关。在白血病中，[1​​8F]FDG PET/CT 可以检测髓外转移和治疗后的治疗反应。因此，PET/CT对于接受CAR-T治疗的患者来说是一种有价值的影像学工具，可用于治疗前评估、监测治疗反应、评估安全性和指导治疗策略。制定针对各种 PET 参数和肿瘤细胞特异性示踪剂的标准化截止值的指南可能会提高 CAR-T 疗法的功效和安全性。© 作者 2024。

Chimeric antigen receptor (CAR)-T cell-based immunotherapy has emerged as a path-breaking strategy for certain hematological malignancies. Assessment of the response to CAR-T therapy using quantitative imaging techniques such as positron emission tomography/computed tomography (PET/CT) has been broadly investigated. However, the definitive role of PET/CT in CAR-T therapy remains to be established. [18F]FDG PET/CT has demonstrated high sensitivity and specificity for differentiating patients with a partial and complete response after CAR-T therapy in lymphoma. The early therapeutic response and immune-related adverse effects such as cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome can also be detected on [18F]FDG PET images. In otherwise asymptomatic lymphoma patients with partial response following CAR-T therapy, the only positive findings could be abnormal PET/CT results. In multiple myeloma, a negative [18F]FDG PET/CT after receiving B-cell maturation antigen-directed CAR-T therapy has been associated with a favorable prognosis. In leukemia, [18F]FDG PET/CT can detect extramedullary metastases and treatment responses after therapy. Hence, PET/CT is a valuable imaging tool for patients undergoing CAR-T therapy for pretreatment evaluation, monitoring treatment response, assessing safety, and guiding therapeutic strategies. Developing guidelines with standardized cutoff values for various PET parameters and tumor cell-specific tracers may improve the efficacy and safety of CAR-T therapy.© The Author(s) 2024.