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Radiologic Evaluation of Gastrointestinal Stromal Tumors ( GISTs)
View City Scan

This series of CT scans and PET scans illustrates some of the possible outcomes following treatment with a KIT inhibitor. Click on the descriptions below to view the images and brief commentary on the interpretation of the findings.


Partial
Responses
Stable
Disease
Limited
Progression
Generalized
Progression
Indeterminate Response

Nodule within a mass1

This is an example of 1 type of limited progression seen in GIST—a nodule within a mass.

Limited progression in GIST presents in several different ways. In this case, limited progression is presented as a nodule within a mass.
In evaluating response in GIST, it's important not to mistake limited progression for generalized progression. Limited-progression GISTs can be treated similarly to local disease, including surgical removal of resectable tumors and procedures such as radiofrequency ablation and hepatic artery embolization in the case of liver metastases.

Scan A

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Scan A is a CT image of a recurrent duodenal GIST at 12 months after treatment initiation. The white arrow points to a tiny nodule within a liver metastasis.
Scan B

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Scan B was taken 17 months after treatment initiation. Here, the arrow points to the same nodule, which has now increased in size, within the metastasis.
Scan C

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Scan C was taken 22 months after treatment initiation. The nodule has continued to increase in size so that it now completely fills the mass.
These images are from a single patient and may not be typical or representative of all patients receiving treatment.
 

Local recurrence at the site of previous disease1,2

This is an example of limited progression featuring local recurrence at a site of previous disease.

Scan A

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Scan A is a CT image of multiple small-bowel GISTs located in the peritoneum and the anterior abdominal wall.
Scan B

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Scan B was taken 14 months after treatment initiation and shows no evidence of the tumors.
Scan C

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Scan C was taken 18 months after treatment initiation. It shows a small lesion that has recurred in the same place as a previous tumor that had been treated successfully.
 
  1. Hong X, Choi H, Loyer EM, Benjamin RS, Trent JC, Charnsangavej C. Gastrointestinal stromal tumor: role of CT in diagnosis and in response evaluations and surveillance after treatment with imatinib. Radiographics. 2006;26(2):481-495.
  2. Trent JC, Benjamin RS. New developments in gastrointestinal stromal tumor. Curr Opin Oncol. 2006;18(4):386-95.
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