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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

Stable disease1

These images highlight stable disease in a patient with GIST. Note: The FDA does not recognize stable disease as a validated measure of response.1

This example demonstrates that in evaluating GIST response, it's important not to mistake stable disease for progression. The fact that the tumor is not shrinking does not necessarily mean that it is progressing.

This type of outcome is characterized by 2 identifying features: no significant change in tumor size and no significant change in tumor
density, as seen on CT images.

Scan A

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Scan A is a CT image of a GIST patient showing a retroperitoneal lymph node metastasis, identified by the white arrow.
Scan B

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Scan B is taken at a point after treatment initiation. The arrow points to the lesion, showing no apparent change in size or density. This signifies stable disease.
These images are from a single patient and may not be typical or representative of all patients receiving treatment.
 
  1. Antoch G, Kanja J, Bauer S, et al. Comparison of PET, CT, and dual-modality PET/CT imaging for monitoring of imatinib (STI571) therapy in patients with gastrointestinal stromal tumors. J Nucl Med. 2004;45(3):357-65.

Images reprinted by permission of the Society of Nuclear Medicine from: Gerald Antoch, Jorg Kanja, Sebastian Bauer, Hilmar Kuehl, Katrin Renzing-Koehler, Jochen Schuette, Andreas Bockish, Jorg F. Debatin, and Lutz S. Freudenberg. Comparison of PET, CT, and Dual-Modality PET/CT Imaging for Monitoring of Imatinib (STI571) Therapy in Patients with Gastrointestinal Stromal Tumors. J Nucl Med. 2004 45(3): 357-365. Figure 3

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