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ECR 2013 / C-0702
MSCT in GIST patients with hepatic metastases treated with new generation tyrosinkinase inhibitors: comparison between density and dimension.
Congress: ECR 2013
Poster No.: C-0702
Type: Scientific Exhibit
Keywords: Oncology, Abdomen, Gastrointestinal tract, CT, Contrast agent-intravenous, Staging, Cancer, Metastases, Monoclonal antibodies
Authors: A. Insalaco, G. Lo Re, F. Muscarneri, F. Patti, M. C. Galfano, L. La Grutta, T. V. Bartolotta, M. Midiri; Palermo/IT
DOI:10.1594/ecr2013/C-0702

Conclusion

The standard imaging technique in advanced GIST patients should be contrast-enhanced CT. CT is widely available, allows high patient comfort, is cost effective and has a high sensitivity in lesion detection, particularly for liver metastases.
We observed that Gist liver lesion responding to targeted therapy showing myxoid degeneration that is reflected by distinctly hypodense, almost cystic-appearing lesions on imaging.
Consequently, CT lesion density should be considered in assessing response.
Whereby, functional response criteria, incorporating tumor density and using small changes in tumor size on CT, are more sensitive and more precise than dimensional criteria in assessing the response of GISTs to TKI targeted therapies. 

Thus, tumor size determined using the sum of the longest dimensions  was not reliable and underestimated the tumor response during the early post treatment stage. By the way, the mean tumor density had decreased significantly 3 months after treatment compared with the pretreatment values.
Authors believe that a larger number of cases will consolidate these findings.

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