Role of computed tomography in the follow-up of hepatic and peritoneal metastases of GIST under imatinib mesylate treatment: A prospective study of 54 patients

Daniel Vanel, Marcela Albiter, Lorraine Shapeero, Axel Le Cesne, Sylvie Bonvalot, Cécile Le Pechoux, Philippe Terrier, Peter Petrow, Hubert Caillet, Clarisse Dromain

Research output: Contribution to journalArticle

Abstract

Purpose: To prospectively analyze the evolution of hepatic and peritoneal unresectable metastases from gastrointestinal stromal tumors (GIST) under imatinib mesylate, a new targeted treatment, which induces changes in lesion structure. Materials and methods: 54 patients with metastases from GIST underwent an abdominal and pelvic computed tomography examination without and with contrast enhancement, before and during treatment with imatinib mesylate. The number and size of lesions and contrast enhancement were noted before treatment and every 2 weeks for the first 2 months, then every 2 months for the first year of treatment and every 3 months thereafter. Results: 27 patients presented with both hepatic and peritoneal metastases, 14 had only peritoneal and 13, only hepatic disease. On baseline imaging, all metastases were hypodense heterogeneous lesions with progressive, concentric enhancement. After treatment (mean duration of follow-up: 23 months) metastases decreased in size number and enhancement in 35/54 patients, remained stable in 2 patients and increased in 14 patients. In 13/39 patients with hepatic metastases a cyst-like appearance was noted. Reactivation after a partial response appeared first as a focal, peripheral, solid nodule in the wall of a cystic lesion, or an increase in lesion density, before size regrew. Conclusion: Besides the classic size criterion, a decrease in density and in contrast enhancement with stable "near cystic" lesions signifies a good response. A more aggressive approach (surgery or radiofrequency ablation) may be indicated for initially focal recurrences with a stable size.

Original languageEnglish
Pages (from-to)118-123
Number of pages6
JournalEuropean Journal of Radiology
Volume54
Issue number1
DOIs
Publication statusPublished - Apr 2005

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Keywords

  • Computer tomography
  • Follow-up
  • Gastrointestinal stromal tumors
  • Imatinib mesylate

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Vanel, D., Albiter, M., Shapeero, L., Le Cesne, A., Bonvalot, S., Le Pechoux, C., Terrier, P., Petrow, P., Caillet, H., & Dromain, C. (2005). Role of computed tomography in the follow-up of hepatic and peritoneal metastases of GIST under imatinib mesylate treatment: A prospective study of 54 patients. European Journal of Radiology, 54(1), 118-123. https://doi.org/10.1016/j.ejrad.2005.01.012