Fig. 2
Transaxial PET/CT images at the cervical level of a 67-year-old melanoma patient undergoing immunotherapy with ipilimumab (a–d). Baseline PET/CT before commencement of therapy showed two hypermetabolic, subcutaneous metastases in the patient’s neck with SUVmax reaching 21.2 (a). After two cycles of ipilimumab, an increase in size and metabolism of the metastases was observed (SUVmax 28.8), leading to uPMD according to EORTC (b). The patient received two more cycles of ipilimumab and was re-examined with PET/CT, which demonstrated persistence of the hypermetabolic disease (SUVmax 25.5) and a further increase in lesions’ size (c). No further treatment was administered and, 4 months later, PET/CT demonstrated a marked morphologic and metabolic (SUVmax 4.2) remission of the lesions (d). Similar to the patient in Fig. 2, the application of PERCIMT classified the patient as SMD, thus tackling the phenomenon of pseudoprogression. At last follow-up the patient was still alive having reached an OS of 66.7 months