{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T23:19:43Z","timestamp":1790983183506,"version":"4.1.0"},"reference-count":30,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,8,30]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:p>\n                    The use of immune checkpoint inhibitors has evolved over the past decade, leading to increased survival in several cancers, including metastatic melanoma. However, the activation of the immune system can cause immune-related adverse events (irAEs), some of which may be potentially fatal. Several irAEs can be visualised on\n                    <jats:sup>18<\/jats:sup>\n                    F-fluorodeoxyglucose positron emission tomography\/CT (\n                    <jats:sup>18<\/jats:sup>\n                    F-FDG PET\/CT), but only a few short cases of immune-related hepatitis have been described in the literature. This case describes thoroughly a course of immune-related hepatitis visualised on a scheduled\n                    <jats:sup>18<\/jats:sup>\n                    F-FDG PET\/CT performed to assess treatment response in a patient treated with combination immunotherapy (ipilimumab and nivolumab) for metastatic melanoma. Although rare, this irAE can be fatal and highlights the importance of assessing the liver when evaluating\n                    <jats:sup>18<\/jats:sup>\n                    F-FDG PET\/CT scans and alerting clinicians in case of suspicious increased FDG uptake in the liver to optimise patient treatment and care.\n                  <\/jats:p>","DOI":"10.1136\/bcr-2025-271081","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T12:35:13Z","timestamp":1788957313000},"page":"e271081","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["<sup>18<\/sup>\n                    F-FDG PET\/CT-visualised immune-related hepatitis after immune checkpoint inhibitor combination treatment in a patient with metastatic melanoma"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0764-4277","authenticated-orcid":false,"given":"Matthias Ploug","family":"Sejrsen","sequence":"first","affiliation":[{"name":"Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina H Bruvik","family":"Ruhlmann","sequence":"additional","affiliation":[{"name":"Department of Oncology, Odense University Hospital, Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8760-3036","authenticated-orcid":false,"given":"Sambavy","family":"Nadaraja","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"2026090905350820000_19.9.e271081.1","doi-asserted-by":"crossref","DOI":"10.1186\/s40164-023-00372-8","article-title":"Increasing cure rates of solid tumors by immune checkpoint inhibitors","volume":"12","author":"Ma","year":"2023","journal-title":"Exp Hematol Oncol"},{"key":"2026090905350820000_19.9.e271081.2","doi-asserted-by":"publisher","DOI":"10.1002\/eji.201646875"},{"key":"2026090905350820000_19.9.e271081.3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1703481"},{"key":"2026090905350820000_19.9.e271081.4","doi-asserted-by":"publisher","DOI":"10.1038\/s41571-019-0218-0"},{"key":"2026090905350820000_19.9.e271081.5","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdx286"},{"key":"2026090905350820000_19.9.e271081.6","doi-asserted-by":"crossref","first-page":"1721","DOI":"10.1001\/jamaoncol.2018.3923","article-title":"Fatal Toxic Effects Associated With Immune Checkpoint Inhibitors","volume":"4","author":"Wang","year":"2018","journal-title":"JAMA Oncol"},{"key":"2026090905350820000_19.9.e271081.7","doi-asserted-by":"crossref","first-page":"245","DOI":"10.23736\/S1824-4785.22.03453-7","article-title":"Adverse effects under immune checkpoint inhibitors on [18F]FDG PET\/CT imaging","volume":"66","author":"Sachpekidis","year":"2022","journal-title":"Q J Nucl Med Mol Imaging"},{"key":"2026090905350820000_19.9.e271081.8","doi-asserted-by":"publisher","DOI":"10.2967\/jnmt.121.262151"},{"key":"2026090905350820000_19.9.e271081.9","doi-asserted-by":"crossref","unstructured":"Gao Y , Wu C , Chen X , et al . PET\/CT molecular imaging in the era of immune-checkpoint inhibitors therapy. Front Immunol 2022;13. doi:10.3389\/fimmu.2022.1049043","DOI":"10.3389\/fimmu.2022.1049043"},{"key":"2026090905350820000_19.9.e271081.10","doi-asserted-by":"crossref","first-page":"191","DOI":"10.15403\/jgld-3508","article-title":"Drug Induced Liver Injury to Immune Checkpoint Inhibitors Detected by F18-Fluorodeoxyglucose PET\/CT","volume":"30","author":"Gabora","year":"2021","journal-title":"J Gastrointestin Liver Dis"},{"key":"2026090905350820000_19.9.e271081.11","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1097\/RLU.0000000000000606","article-title":"Ipilimumab-induced hepatitis on 18F-FDG PET\/CT in a patient with malignant melanoma","volume":"40","author":"Raad","year":"2015","journal-title":"Clin Nucl Med"},{"key":"2026090905350820000_19.9.e271081.12","doi-asserted-by":"crossref","unstructured":"Iravani A , Hicks RJ . Pitfalls and immune-related adverse events. In: Lopci E , Fanti S , eds. Atlas of response to immunotherapy. Cham: Springer International Publishing, 2020: 101\u201315.","DOI":"10.1007\/978-3-030-31113-1_10"},{"key":"2026090905350820000_19.9.e271081.13","doi-asserted-by":"crossref","DOI":"10.1016\/j.ejro.2022.100434","article-title":"Imaging features of toxicities associated with immune checkpoint inhibitors","volume":"9","author":"Gosangi","year":"2022","journal-title":"Eur J Radiol Open"},{"key":"2026090905350820000_19.9.e271081.14","doi-asserted-by":"crossref","DOI":"10.3389\/fphar.2017.00049","article-title":"Current Diagnosis and Management of Immune Related Adverse Events (irAEs) Induced by Immune Checkpoint Inhibitor Therapy","volume":"8","author":"Kumar","year":"2017","journal-title":"Front Pharmacol"},{"key":"2026090905350820000_19.9.e271081.15","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1007\/s40336-024-00618-3","article-title":"Value of 2-[18F]FDG-PET\/CT in identifying immune-related adverse events in patients with melanoma or non-small cell lung cancer: a systematic scoping review","volume":"12","author":"Nadaraja","year":"2024","journal-title":"Clin Transl Imaging"},{"key":"2026090905350820000_19.9.e271081.16","doi-asserted-by":"crossref","DOI":"10.3389\/fimmu.2023.1133207","article-title":"Imaging assessment of toxicity related to immune checkpoint inhibitors","volume":"14","author":"Berz","year":"2023","journal-title":"Front Immunol"},{"key":"2026090905350820000_19.9.e271081.17","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1038\/s41572-020-0160-6","article-title":"Immune-related adverse events of checkpoint inhibitors","volume":"6","author":"Ramos-Casals","year":"2020","journal-title":"Nat Rev Dis Primers"},{"key":"2026090905350820000_19.9.e271081.18","doi-asserted-by":"crossref","first-page":"1077468","DOI":"10.3389\/fphar.2022.1077468","article-title":"Immune-mediated hepatitis induced by immune checkpoint inhibitors: Current updates and future perspectives","volume":"13","author":"Liu","year":"2023","journal-title":"Front Pharmacol"},{"key":"2026090905350820000_19.9.e271081.19","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.21.01440"},{"key":"2026090905350820000_19.9.e271081.20","doi-asserted-by":"crossref","DOI":"10.1136\/jitc-2021-002435","article-title":"Society for Immunotherapy of Cancer (SITC) clinical practice guideline on immune checkpoint inhibitor-related adverse events","volume":"9","author":"Brahmer","year":"2021","journal-title":"J Immunother Cancer"},{"key":"2026090905350820000_19.9.e271081.21","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdx225"},{"key":"2026090905350820000_19.9.e271081.22","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2019.0013"},{"key":"2026090905350820000_19.9.e271081.23","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1200\/EDBK_100013","article-title":"Gastrointestinal and Hepatic Toxicities of Checkpoint Inhibitors: Algorithms for Management","volume":"38","author":"Grover","year":"2018","journal-title":"Am Soc Clin Oncol Educ Book"},{"key":"2026090905350820000_19.9.e271081.24","doi-asserted-by":"crossref","first-page":"102514","DOI":"10.1016\/j.jaut.2020.102514","article-title":"Best practices for detection, assessment and management of suspected immune-mediated liver injury caused by immune checkpoint inhibitors during drug development","volume":"114","author":"Regev","year":"2020","journal-title":"J Autoimmun"},{"key":"2026090905350820000_19.9.e271081.25","doi-asserted-by":"crossref","first-page":"S47","DOI":"10.1007\/s40264-014-0185-4","article-title":"Causality assessment for suspected DILI during clinical phases of drug development","volume":"37 Suppl 1","author":"Regev","year":"2014","journal-title":"Drug Saf"},{"key":"2026090905350820000_19.9.e271081.26","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdx158"},{"key":"2026090905350820000_19.9.e271081.27","doi-asserted-by":"crossref","first-page":"2323","DOI":"10.1007\/s00259-022-05780-2","article-title":"Joint EANM\/SNMMI\/ANZSNM practice guidelines\/procedure standards on recommended use of [18F]FDG PET\/CT imaging during immunomodulatory treatments in patients with solid tumors version 1.0","volume":"49","author":"Lopci","year":"2022","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"2026090905350820000_19.9.e271081.28","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctrv.2020.102134"},{"key":"2026090905350820000_19.9.e271081.29","doi-asserted-by":"crossref","first-page":"e272","DOI":"10.1097\/RLU.0000000000002453","article-title":"Predicting Response to Immunotherapy by Evaluating Tumors, Lymphoid Cell-Rich Organs, and Immune-Related Adverse Events Using FDG-PET\/CT","volume":"44","author":"Nobashi","year":"2019","journal-title":"Clin Nucl Med"},{"key":"2026090905350820000_19.9.e271081.30","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2021.633032"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-271081","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T12:35:17Z","timestamp":1788957317000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-271081"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":30,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9,9]]},"published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1136\/bcr-2025-271081"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-271081","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]}}}