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.