Restricted accessReview articleFirst published online 2013-9
The benefit of using CT-perfusion imaging for reliable response monitoring in patients with gastrointestinal stromal tumor (GIST) undergoing treatment with novel targeted agents
Solely size-based response criteria may be unreliable in patients with gastrointestinal stromal tumors (GIST) treated with tyrosine kinase inhibitors, because they typically underestimate responses to treatment. As GISTs are generally hypervascularized and novel targeted drugs knowingly affect angiogenic signaling pathways, perfusion measurements are expected to deliver important information about their efficacy. This pictorial essay illustrates the benefit of using complementary CT-perfusion-based measurements for more accurate evaluation of response to therapy in GIST.
DemetriGDBenjaminRSBlankeCDNCCN task force report: optimal management of patients with gastrointestinal stromal tumor (GIST)-update of the NCCN clinical practice guidelines. J Natl Compr Cancer Netw2007;5:1–29
2.
KindblomLGRemottiHEAldenborgFGastrointestinal pacemaker cell tumor (GIPACT): gastrointestinal stromal tumor show phenotypic characteristics of the intestinal cells of Cajal. Am J Pathol1998;152:1259–69
DeMatteoRPLewisJJLeungDTwo hundred gastrointestinal stromal tumors: recurrence patterns and prognostic factors for survival. Ann Surg2000;231:51
5.
BurkillGJBadranMAl-MuderisOMalignant gastrointestinal stromal tumor: distribution, imaging features, and pattern of metastatic spread. Radiology2003;226:527–32
6.
MiettinenMLasotaJ. Gastrointestinal stromal tumors: pathology and prognosis at different sites. Semin Diagn Pathol2006;23:71–83
7.
JudsonIDemetriG. Advanves in the treatment of gastrointestinal stromal tumour. Ann Oncol2007;18:20–4
8.
WongCSChuYCKhongPL. Unusual features of gastrointestinal stromal tumor on PET/CT and CT imaging. Clin Nucl Med2011;36:e1–7
9.
PantaleoMANanniniMSaponaraM; GIST Study Group, University of Bologna, Bologna, Italy. Impressive long-term disease stabilization by nilotinib in two pretreated patients with KIT/PDGFRA wild-type metastatic gastrointestinal stromal tumours. Anticancer Drugs2012;23:567–72
10.
DudeckOZeileMReichardtPComparison of RECIST and Choi criteria for computed tomographic response evaluation in patients with advanced gastrointestinal stromal tumor treated with sunitinib. Ann Oncol2011;22:1828–33
11.
RossiFYozgatYde StanchinaEImatinib upregulates compensatory integrin signaling in a mouse model of gastrointestinal stromal tumor and is more effective when combined with dasatinib. Mol Cancer Res2010;8:1271–83
12.
De GiorgiUAlibertiCBeneaGEffect of angiosonography to monitor response during imatinib treatment in patients with metastatic gastrointestinal stromal tumors. Clin Cancer Res2005;11:6171–6
13.
ChoiHCharnsangavejCFariaSCCorrelation of computed tomographie and positron emission tomographie in patients with metastatic gastrointestinal stromal tumor treated at a single institution with imatinib mesylate: proposal of new computed tompgraphie response criteria. J Clin Oncol2007;25:1753–9
14.
StacchiottiSColliniPMessinaAHigh-grade soft-tissue sarcomas: tumor response assessment–pilot study to assess the correlation between radiologic and pathologic response by using RECIST and Choi criteria. Radiology2009;251:447–56
15.
PetraliaGPredaLD'AndreaGCT perfusion in solid-body tumours. Part I: technical issues. Radiol Med2010;115:843–57
16.
MilesKA. Perfusion CT for the assessment of tumour vascularity: which protocol?Br J Radiol2003;76:S36–42
17.
MilesKACharnsangavejCLeeFTApplication of CT in the investigation of angiogenesis in oncology. Acad Radiol2000;7:840–50
18.
KambadakoneARSahaniDV. Body perfusion CT: technique, clinical applications, and advances. Radiol Clin North Am2009;47:161–78
19.
SauterAWMerkleASchulzeMIntraobserver and interobserver agreement of volume perfusion CT (VPCT) measurements in patients with lung lesions. Eur J Radiol2012;81:2853–9
20.
HayanoKShutoKKodaKQuantitative measurement of blood flow using perfusion CT for assessing clinicopathologic features and prognosis in patients with rectal cancer. Dis Colon Rectum2009;52:1624–9
21.
GohVHalliganSWellstedDMCan perfusion CT assessment of primary colorectal adenocarcinoma blood flow at staging predict for subsequent metastatic disease? A pilot study. Eur Radiol2009;19:79–89
22.
PetraliaGBonelloLViottiSCT perfusion in oncology: how to do it. Cancer Imaging2010;10:8–19
23.
HermansRMeijerinkMVan den BogaertWTumor perfusion rate determined noninvasively by dynamic computed tomography predicts outcome in head-and-neck cancer after radiotherapy. Int J Radiat Oncol Biol Phys2003;57:1351–6
24.
FournierLSOudardSThiamRMetastatic renal carcinoma: evaluation of antiangiogenic therapy with dynamic contrast-enhanced CT. Radiology2010;256:511–8
25.
LassauNLamuragliaMChamiLGastrointestinal stromal tumors treated with imatinib: monitoring response with contrast-enhanced sonography. Am J Roentgenol2006;187:1267–73
26.
AntochGKaniaJBauerSComparison of PET, CT and dual-modality PET/CT imaging for monitoring of imatinib (STI-%/!) therapy in patients with gastrointestinal stromal tumors.J Nucl Med2004;45:357–65
27.
SchlemmerMSourbronSPSchinwaldNPerfusion patterns of metastatic gastrointestinal stromal tumor lesions under specific molecular therapy. Eur J Rad2011;77:312–18
28.
HuynhHLeeJWChowPKSorafenib induces growth suppression in mouse models of gastrointestinal stromal tumor. Mol Cancer Ther2009;8:152–9
29.
ReichardtPSchneiderUStroszczynskiCMolecular response of gastrointestinal stromal tumour after treatment with tyrosine kinase inhibitor imatinib mesylate.J Clin Pathol2004;57:215–7
30.
IzawaNSawadaTAbikoRGastrointestinal stromal tumor presenting with prominent calcification. World J Gastroenterol2012;18:5645–8
31.
JoensuuHTrentJCReichardtP. Practical management of tyrosine kinase inhibitor-associated side effects in GIST. Cancer Treat Rev2011;37:75–88
32.
LassauNChamiLChebilMDynamic contrast-enhanced ultrasonography (DCE-US) and anti-angiogenic treatments. Discov Med2011;11:18–24
33.
ShankarSvanSonnenbergEDesaiJGastrointestinal stromal tumor: new nodule-within-a-mass pattern of recurrence after partial response to imatinib mesylate. Radiology2005;235:892–8
34.
RyuMHLeeJLChangHMPatterns of progression in gastrointestinal stromal tumor treated with imatinib mesylate. Jpn J Clin Oncol2006;36:17–24
