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Published on: January 22, 2018
Perfusion patterns of metastatic gastrointestinal stromal tumor lesions under specific molecular therapy
Marcus Schlemmer1, Steven P Sourbron, Nicole Schinwald
1Department of Internal Medicine III, University Hospitals-Großhadern, Ludwig Maximilians University Munich, Marchioninistr 15, 81377 Munich, Germany.
Rationale And Objective:
The aim of this pilot study was the evaluation of CT perfusion patterns in metastatic GIST lesions under specific molecular therapy with sunitinib or imatinib both in responders and non-responders.
Patients And Methods:
24 patients with metastatic GIST under tyrosine kinase inhibition were retrospectively evaluated. A total of 46 perfusion and venous phase CT scans were acquired. Volume of distribution, blood flow, blood volume, permeability and hepatic perfusion index measurements of metastatic lesions were carried out. Lesions were classified as "good response" or "poor response" to therapy, and perfusion parameters were compared for these two types of lesions.
Results:
24 patients were evaluated. In the extrahepatic abdominal lesions (N = 15), good responders showed significant lower perfusion values than poor responders (volume of distribution: 3.3 ± 2.0 vs. 13.0 ± 1.8 ml/100ml, p = 0.001). The same tendency was observed in intrahepatic lesions (N = 31) (liver volume of distribution: 2.1 ± 0.3 vs. 7.1 ± 1.3 ml/100ml, p = 0.003); (hepatic perfusion index: 24.3 ± 7.9 vs. 76.1 ± 1.5%, p = 0.0001).
Conclusion:
Our data indicate that there are characteristic perfusion patterns of metastatic GIST lesions showing a good or poor response to molecular pharmacotherapy. Perfusion should be further evaluated in cross-sectional imaging studies as a possible biomarker for treatment response in targeted therapies of GIST.
Insights
CT perfusion patterns can predict treatment response in metastatic gastrointestinal stromal tumors (GIST) receiving targeted therapies. Lower perfusion values in GIST lesions indicate a good response to molecular therapy.
Area of Science:
- Radiology and Medical Imaging
- Oncology
- Pharmacotherapy
Background:
- Metastatic gastrointestinal stromal tumors (GIST) are often treated with molecular therapies like sunitinib or imatinib.
- Evaluating treatment response is crucial for patient management and therapeutic adjustments.
Purpose of the Study:
- To assess if CT perfusion patterns can differentiate responders from non-responders in metastatic GIST patients undergoing molecular therapy.
- To identify potential imaging biomarkers for treatment efficacy.
Main Methods:
- Retrospective analysis of 24 metastatic GIST patients treated with tyrosine kinase inhibitors.
- Acquisition and analysis of 46 CT perfusion and venous phase scans.
- Measurement of perfusion parameters including volume of distribution, blood flow, blood volume, and hepatic perfusion index.
Main Results:
- Good responders exhibited significantly lower perfusion values (volume of distribution) in both extrahepatic and intrahepatic GIST lesions compared to poor responders.
- A notable difference was observed in the hepatic perfusion index between good and poor responders.
Conclusions:
- Characteristic CT perfusion patterns are associated with response to molecular therapy in metastatic GIST.
- Perfusion parameters show promise as imaging biomarkers for assessing treatment response in targeted GIST therapies.
