Correlation of computed tomography and positron emission tomography in patients with metastatic gastrointestinal stromal tumor treated at a single institution with imatinib mesylate: Proposal of new computed tomography response criteria
Correlation of computed tomography and positron emission tomography in patients with metastatic gastrointestinal stromal tumor treated at a single institution with imatinib mesylate: Proposal of new computed tomography response criteria
复制标题
DOI：
10.1200/jco.2006.07.3049
复制
发表时间：
2007-05-01
影响因子：
45.3
通讯作者：
Benjamin, Robert S.
中科院分区：
文献类型：
--
作者：
Choi, Haesun;Charnsangavej, Chuslip;Benjamin, Robert S.
实体瘤疗效评价标准（RECIST）对伊马替尼治疗胃肠道间质瘤（GIST）不敏感。本研究评估了伊马替尼治疗后GIST的计算机断层扫描（CT）结果是否与肿瘤反应[（18）F]氟脱氧葡萄糖（FDG）正电子发射断层扫描（PET），并制定了可靠的，定量的，CT反应criterial.Patients和MethodsA共172个病灶的RECIST选择伊马替尼治疗转移性GIST的40例患者进行了评价。所有患者均接受了治疗前和2个月随访CT和FDG-PET。使用CT上的肿瘤大小和密度（Hounsfield单位[HU]）和FDG-PET上的最大标准化摄取值（SUV（max））进行多变量分析。患者观察到28 months.ResultsMean基线肿瘤大小和密度CT分别为5.3厘米和72.8 HU，平均基线SUV（最大）FDG-PET为5.8。33例患者FDG-PET反应良好。CT上肿瘤大小减少超过10%或肿瘤密度减少超过15%，识别PET应答者的敏感性为97%，特异性为100%，而RECIST为52%和100%。良好的反应者在CT上2个月有显着较长的时间进展比那些没有回应（P =.01）。结论CT上的肿瘤大小或密度的小变化是敏感和具体的方法评估GIST的反应。如果我们提出的CT反应标准的预后价值可以被前瞻性地证实，该标准应在未来的GIST患者的研究中使用。
PurposeResponse Evaluation Criteria in Solid Tumors (RECIST) are insensitive in evaluating gastrointestinal stromal tumors (GISTs) treated with imatinib. This study evaluates whether computed tomography (CT) findings of GIST after imatinib treatment correlate with tumor responses by [(18)F] fluorodeoxyglucose (FDG) positron emission tomography ( PET) and develops reliable, quantitative, CT response criteria.Patients and MethodsA total of 172 lesions selected by RECIST were evaluated in 40 patients with metastatic GISTs treated with imatinib. All patients had pretreatment and 2-month follow-up CTs and FDG-PETs. Multivariate analysis was performed using tumor size and density (Hounsfield unit [HU]) on CT and maximum standardized uptake value (SUV(max)) on FDG-PET. Patients were observed up to 28 months.ResultsMean baseline tumor size and density on CT were 5.3 cm and 72.8 HU, respectively, and mean baseline SUV(max) on FDG-PET was 5.8. Thirty-three patients had good response on FDG-PET. A decrease in tumor size of more than 10% or a decrease in tumor density of more than 15% on CT had a sensitivity of 97% and a specificity of 100% in identifying PET responders versus 52% and 100% by RECIST. Good responders on CT at 2 months had significantly longer time to progression than those who did not respond ( P =.01).ConclusionSmall changes in tumor size or density on CT are sensitive and specific methods of assessing the response of GISTs. If the prognostic value of our proposed CT response criteria can be confirmed prospectively, the criteria should be employed in future studies of patients with GIST.