Computed tomography and magnetic resonance imaging in the evaluation of treatment response of targeted therapy for gastrointestinal stromal tumor_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LIU Xijiao , YANG Caiwei , HUANG Zixing ,  SONG Bin

Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

SONG Bin, Email: ajr.songbin@vip.163.com

Keywords：

gastrointestinal stromal tumor; targeted therapy; computed tomography; magnetic resonance imaging; review

DOI：

10.7507/1007-9424.201908117

Video：

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Objective This review has summarized in detail the advances in computed tomography (CT) and magnetic resonance imaging (MRI) imaging in evaluating the efficacy of targeted therapy for gastrointestinal stromal tumor (GIST).Methods To summarize the image-related guidelines, consensus, international conference reports, and relevant knowledge of clinical research on the evaluation of the efficacy of GIST targeted therapy in recent years.Results The CT and MRI manifestation after targeted treatment of GIST was closely related to pathological changes, including necrosis, cystic degeneration, and bleeding. CT was the preferred imaging method. Functional magnetic resonance imaging, such as diffusion weighted imaging (DWI), had made some progress. The main criteria for evaluating the efficacy of GIST targeted therapy were RECIST 1.1 and Choi criteria.Conclusion CT and MRI play an important role in evaluating the efficacy of targeted therapy for GIST.

Citation： LIU Xijiao, YANG Caiwei, HUANG Zixing, SONG Bin. Computed tomography and magnetic resonance imaging in the evaluation of treatment response of targeted therapy for gastrointestinal stromal tumor. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2019, 26(10): 1239-1242. doi: 10.7507/1007-9424.201908117 Copy

1.	Nishida T, Hirota S. Biological and clinical review of stromal tumors in the gastrointestinal tract. Histol Histopathol, 2000, 15(4): 1293-1301.
2.	中国临床肿瘤学会胃肠间质瘤专家委员会. 中国胃肠间质瘤诊断治疗共识 (2017年版). 肿瘤综合治疗电子杂志, 2018, 4(1): 31-43.
3.	Judson I, Bulusu R, Seddon B, et al. UK clinical practice guidelines for the management of gastrointestinal stromal tumours (GIST). Clin Sarcoma Res, 2017, 7: 6.
4.	Vernuccio F, Taibbi A, Picone D, et al. Imaging of gastrointestinal stromal tumors: from diagnosis to evaluation of therapeutic response. Anticancer Res, 2016, 36(6): 2639-2648.
5.	Ekert K, Hinterleitner C, Horger M. Prognosis assessment in metastatic gastrointestinal stromal tumors treated with tyrosine kinase inhibitors based on CT-texture analysis. Eur J Radiol, 2019, 116: 98-105.
6.	Hirota S, Isozaki K, Moriyama Y, et al. Gain-of-function mutations of c-kit in human gastrointestinal stromal tumors. Science, 1998, 279(5350): 577-580.
7.	Fletcher CDM, Bridge JA, Hogendoorn PCW, et al. WHO classfication of tumours of soft tissue and bone. 4^th ed, Lyon: LARC Press, 2013: 164-167.
8.	Li GZ, Raut CP. Targeted therapy and personalized medicine in gastrointestinal stromal tumors: drug resistance, mechanisms, and treatment strategies. Onco Targets Ther, 2019, 12: 5123-5133.
9.	曹晖, 汪明. 胃肠间质瘤综合诊治中若干焦点问题思考. 中国实用外科杂志, 2018, 38(5): 485-493.
10.	Heinrich MC, Jones RL, von Mehren M, et al. Clinical activity of avapritinib in ≥ fourth-line (4L+) and PDGFRA Exon 18 gastrointestinal stromal tumors (GIST). American Annual Conference of Clinical Oncology, Chicago, USA, 2019.
11.	Eisenhauer EA, Therasse P, Bogaerts J, et al. New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer, 2009, 45(2): 228-247.
12.	Choi H, Charnsangavej C, de Castro Faria S, et al. CT evaluation of the response of gastrointestinal stromal tumors after imatinib mesylate treatment: a quantitative analysis correlated with FDG PET findings. AJR Am J Roentgenol, 2004, 183(6): 1619-1628.
13.	Hong X, Choi H, Loyer EM, et al. Gastrointestinal stromal tumor: role of CT in diagnosis and in response evaluation and surveillance after treatment with imatinib. Radiographics, 2006, 26(2): 481-495.
14.	Choi H. Response evaluation of gastrointestinal stromal tumors. Oncologist, 2008, 13(Suppl 2): 4-7.
15.	Dudeck O, Zeile M, Reichardt P, et al. Comparison of RECIST and Choi criteria for computed tomographic response evaluation in patients with advanced gastrointestinal stromal tumor treated with sunitinib. Ann Oncol, 2011, 22(8): 1828-1833.
16.	Meyer M, Hohenberger P, Apfaltrer P, et al. CT-based response assessment of advanced gastrointestinal stromal tumor: dual energy CT provides a more predictive imaging biomarker of clinical benefit than RECIST or Choi criteria. Eur J Radiol, 2013, 82(6): 923-928.
17.	Apfaltrer P, Meyer M, Meier C, et al. Contrast-enhanced dual-energy CT of gastrointestinal stromal tumors: is iodine-related attenuation a potential indicator of tumor response? Invest Radiol, 2012, 47(1): 65-70.
18.	Kalkmann J, Zeile M, Antoch G, et al. Consensus report on the radiological management of patients with gastrointestinal stromal tumours (GIST): recommendations of the German GIST Imaging Working Group. Cancer Imaging, 2012, 12: 126-135.
19.	Koh Y, Lee HE, Oh DY, et al. The lack of CD34 expression in gastrointestinal stromal tumors is related to cystic degeneration following imatinib use. Jpn J Clin Oncol, 2012, 42(11): 1020-1027.
20.	Werewka-Maczuga A, Stępień M, Urbanik A. Evaluation of alterations in tumor tissue of gastrointestinal stromal tumor (GIST) in computed tomography following treatment with imatinib. Pol J Radiol, 2017, 82: 817-826.
21.	Levy AD, Remotti HE, Thompson WM, et al. Gastrointestinal stromal tumors: radiologic features with pathologic correlation. Radiographics, 2003, 23(2): 283-304.
22.	张晓鹏, 唐磊. 胃肠间质瘤靶向治疗影像学评估. 中国实用外科杂志, 2010, 30(4): 278-281.
23.	Shankar S, vanSonnenberg E, Desai J, et al. Gastrointestinal stromal tumor: new nodule-within-a-mass pattern of recurrence after partial response to Imatinib mesylate. Radiology, 2005, 235(3): 892-898.
24.	Mabille M, Vanel D, Albiter M, et al. Follow-up of hepatic and peritoneal metastases of gastrointestinal tumors (GIST) under Imatinib therapy requires different criteria of radiological evaluation (size is not everything!!!). Eur J Radiol, 2009, 69(2): 204-208.
25.	Linton KM, Taylor MB, Radford JA. Response evaluation in gastrointestinal stromal tumours treated with imatinib: misdiagnosis of disease progression on CT due to cystic change in liver metastases. Br J Radiol, 2006, 79(944): e40-e44.
26.	Herzberg M, Beer M, Anupindi S, et al. Imaging pediatric gastrointestinal stromal tumor (GIST). J Pediatr Surg, 2018, 53(9): 1862-1870.
27.	Revheim ME, Hole KH, Bruland OS, et al. Multimodal functional imaging for early response assessment in GIST patients treated with imatinib. Acta Oncol, 2014, 53(1): 143-148.
28.	Tang L, Zhang XP, Sun YS, et al. Gastrointestinal stromal tumors treated with imatinib mesylate: apparent diffusion coefficient in the evaluation of therapy response in patients. Radiology, 2011, 258(3): 729-738.
29.	Tang L, Li J, Li ZY, et al. MRI in predicting the response of gastrointestinal stromal tumor to targeted therapy: a patient-based multi-parameter study. BMC Cancer, 2018, 18(1): 811.

1. Nishida T, Hirota S. Biological and clinical review of stromal tumors in the gastrointestinal tract. Histol Histopathol, 2000, 15(4): 1293-1301.
2. 中国临床肿瘤学会胃肠间质瘤专家委员会. 中国胃肠间质瘤诊断治疗共识 (2017年版). 肿瘤综合治疗电子杂志, 2018, 4(1): 31-43.
3. Judson I, Bulusu R, Seddon B, et al. UK clinical practice guidelines for the management of gastrointestinal stromal tumours (GIST). Clin Sarcoma Res, 2017, 7: 6.
4. Vernuccio F, Taibbi A, Picone D, et al. Imaging of gastrointestinal stromal tumors: from diagnosis to evaluation of therapeutic response. Anticancer Res, 2016, 36(6): 2639-2648.
5. Ekert K, Hinterleitner C, Horger M. Prognosis assessment in metastatic gastrointestinal stromal tumors treated with tyrosine kinase inhibitors based on CT-texture analysis. Eur J Radiol, 2019, 116: 98-105.
6. Hirota S, Isozaki K, Moriyama Y, et al. Gain-of-function mutations of c-kit in human gastrointestinal stromal tumors. Science, 1998, 279(5350): 577-580.
7. Fletcher CDM, Bridge JA, Hogendoorn PCW, et al. WHO classfication of tumours of soft tissue and bone. 4^th ed, Lyon: LARC Press, 2013: 164-167.
8. Li GZ, Raut CP. Targeted therapy and personalized medicine in gastrointestinal stromal tumors: drug resistance, mechanisms, and treatment strategies. Onco Targets Ther, 2019, 12: 5123-5133.
9. 曹晖, 汪明. 胃肠间质瘤综合诊治中若干焦点问题思考. 中国实用外科杂志, 2018, 38(5): 485-493.
10. Heinrich MC, Jones RL, von Mehren M, et al. Clinical activity of avapritinib in ≥ fourth-line (4L+) and PDGFRA Exon 18 gastrointestinal stromal tumors (GIST). American Annual Conference of Clinical Oncology, Chicago, USA, 2019.
11. Eisenhauer EA, Therasse P, Bogaerts J, et al. New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer, 2009, 45(2): 228-247.
12. Choi H, Charnsangavej C, de Castro Faria S, et al. CT evaluation of the response of gastrointestinal stromal tumors after imatinib mesylate treatment: a quantitative analysis correlated with FDG PET findings. AJR Am J Roentgenol, 2004, 183(6): 1619-1628.
13. Hong X, Choi H, Loyer EM, et al. Gastrointestinal stromal tumor: role of CT in diagnosis and in response evaluation and surveillance after treatment with imatinib. Radiographics, 2006, 26(2): 481-495.
14. Choi H. Response evaluation of gastrointestinal stromal tumors. Oncologist, 2008, 13(Suppl 2): 4-7.
15. Dudeck O, Zeile M, Reichardt P, et al. Comparison of RECIST and Choi criteria for computed tomographic response evaluation in patients with advanced gastrointestinal stromal tumor treated with sunitinib. Ann Oncol, 2011, 22(8): 1828-1833.
16. Meyer M, Hohenberger P, Apfaltrer P, et al. CT-based response assessment of advanced gastrointestinal stromal tumor: dual energy CT provides a more predictive imaging biomarker of clinical benefit than RECIST or Choi criteria. Eur J Radiol, 2013, 82(6): 923-928.
17. Apfaltrer P, Meyer M, Meier C, et al. Contrast-enhanced dual-energy CT of gastrointestinal stromal tumors: is iodine-related attenuation a potential indicator of tumor response? Invest Radiol, 2012, 47(1): 65-70.
18. Kalkmann J, Zeile M, Antoch G, et al. Consensus report on the radiological management of patients with gastrointestinal stromal tumours (GIST): recommendations of the German GIST Imaging Working Group. Cancer Imaging, 2012, 12: 126-135.
19. Koh Y, Lee HE, Oh DY, et al. The lack of CD34 expression in gastrointestinal stromal tumors is related to cystic degeneration following imatinib use. Jpn J Clin Oncol, 2012, 42(11): 1020-1027.
20. Werewka-Maczuga A, Stępień M, Urbanik A. Evaluation of alterations in tumor tissue of gastrointestinal stromal tumor (GIST) in computed tomography following treatment with imatinib. Pol J Radiol, 2017, 82: 817-826.
21. Levy AD, Remotti HE, Thompson WM, et al. Gastrointestinal stromal tumors: radiologic features with pathologic correlation. Radiographics, 2003, 23(2): 283-304.
22. 张晓鹏, 唐磊. 胃肠间质瘤靶向治疗影像学评估. 中国实用外科杂志, 2010, 30(4): 278-281.
23. Shankar S, vanSonnenberg E, Desai J, et al. Gastrointestinal stromal tumor: new nodule-within-a-mass pattern of recurrence after partial response to Imatinib mesylate. Radiology, 2005, 235(3): 892-898.
24. Mabille M, Vanel D, Albiter M, et al. Follow-up of hepatic and peritoneal metastases of gastrointestinal tumors (GIST) under Imatinib therapy requires different criteria of radiological evaluation (size is not everything!!!). Eur J Radiol, 2009, 69(2): 204-208.
25. Linton KM, Taylor MB, Radford JA. Response evaluation in gastrointestinal stromal tumours treated with imatinib: misdiagnosis of disease progression on CT due to cystic change in liver metastases. Br J Radiol, 2006, 79(944): e40-e44.
26. Herzberg M, Beer M, Anupindi S, et al. Imaging pediatric gastrointestinal stromal tumor (GIST). J Pediatr Surg, 2018, 53(9): 1862-1870.
27. Revheim ME, Hole KH, Bruland OS, et al. Multimodal functional imaging for early response assessment in GIST patients treated with imatinib. Acta Oncol, 2014, 53(1): 143-148.
28. Tang L, Zhang XP, Sun YS, et al. Gastrointestinal stromal tumors treated with imatinib mesylate: apparent diffusion coefficient in the evaluation of therapy response in patients. Radiology, 2011, 258(3): 729-738.
29. Tang L, Li J, Li ZY, et al. MRI in predicting the response of gastrointestinal stromal tumor to targeted therapy: a patient-based multi-parameter study. BMC Cancer, 2018, 18(1): 811.

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Computed tomography and magnetic resonance imaging in the evaluation of treatment response of targeted therapy for gastrointestinal stromal tumor

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