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1.
Rev Esp Med Nucl ; 25(2): 80-8, 2006.
Article in Spanish | MEDLINE | ID: mdl-16759613

ABSTRACT

INTRODUCTION: Gastrointestinal stromal tumors (GISTs) account for almost 4 % of all gastrointestinal neoplasms. Recently, a new type of tyrosine kinase inhibitor (Glivec), has been successfully used in patients with metastasic or unresectable disease. The aim of the study is to show the utility of PET in the staging, recurrence and treatment response to Glivec in GIST tumors. MATERIALS AND METHODS: 48 whole body FDG-PET studies in 27 patients with GIST (19 men/mean age = 56 y) were evaluated for initial staging (n = 13), recurrence (n = 15) or treatment response to Glivec (n = 20). Images were acquired in a whole body 2D mode using attenuation correction on an Advance Nxi G.E.MS camera and were evaluated visually and quantatively using SUV analysis. Results were compared with radiological findings, hystological confirmation or follow-up. RESULTS: In the initial staging evaluation, FDG-PET shows a more extensive disease than suspected in 3/10 patients. In other 3 patients PET ruled out mesenteric or peritoneal disease. In the evaluation of treatment response to Glivec, FDG-PET showed a good response in eleven patients (complete response in seven and partial response in four). In this group a sixty percent decrease of the SUV max was assessed. Two patients showed no response to Glivec at doses of 400 mg or 800 mg, showing a stable SUV value and/or increased in some abdominal lesions. PET detected recurrence in one patient. CONCLUSIONS: This study show how FDG-PET is accurate in the early treatment response to Glivec. PET could be helpful in the staging and recurrence of GIST tumors.


Subject(s)
Antineoplastic Agents/therapeutic use , Gastrointestinal Stromal Tumors/diagnostic imaging , Piperazines/therapeutic use , Positron-Emission Tomography , Protein Kinase Inhibitors/therapeutic use , Pyrimidines/therapeutic use , Adult , Aged , Benzamides , Drug Resistance, Neoplasm , Female , Fluorodeoxyglucose F18 , Gastrointestinal Stromal Tumors/drug therapy , Gastrointestinal Stromal Tumors/pathology , Humans , Imatinib Mesylate , Male , Middle Aged , Neoplasm Metastasis/diagnostic imaging , Neoplasm Recurrence, Local/diagnostic imaging , Neoplasm Staging/methods , Radiopharmaceuticals , Stomach Neoplasms
2.
Rev. esp. med. nucl. (Ed. impr.) ; 25(2): 80-88, mar. 2006. ilus, tab
Article in Es | IBECS | ID: ibc-046473

ABSTRACT

ntroducción. Los tumores del estroma gastrointestinal (GIST) pueden presentarse como una enfermedad diseminada. Un inhibidor de la tirosina-quinasa (Glivec) ha obtenido respuestas espectaculares en pacientes con enfermedad irresecable. El objetivo de este estudio fue mostrar la utilidad de la tomografía por emisión de positrones-fluorodesoxiglucosa (PET-FDG) en la estadificación inicial, en la recurrencia y en la valoración precoz de la respuesta al Glivec. Material y métodos. Realizamos 48 estudios con PET en 27 pacientes (19 varones/edad media = 56a): estadificación inicial (n = 13), valoración de enfermedad recurrente (n = 15) y respuesta al tratamiento con imatinib (n = 20). La valoración de los estudios se realizó mediante análisis visual y semicuantitativo (SUV [standardized uptake value]). Los resultados se confirmaron mediante seguimiento, pruebas de imagen y/o histología. Resultados. En la estadificación inicial, la PET mostró una mayor extensión de la enfermedad en 3/10 de los pacientes evaluados. En otros 3 pacientes evitamos la administración adyuvante de imatinib. La PET mostró una correcta respuesta terapéutica en once de los trece pacientes evaluados (completa en siete y parcial en cuatro). La disminución media del SUV en los respondedores parciales fue del 60 %. Dos pacientes no mostraron disminución de la captación del trazador con dosis de 400 ni de 800 mg de Glivec, permaneciendo el SUV estable y/o aumentado la intensidad de captación en algunas lesiones. Asimismo, la PET detectó una recurrencia tumoral en un paciente. Conclusiones. Este estudio muestra cómo la PET-FDG es una técnica útil en la valoración precoz de la respuesta terapéutica al imatinib. La PET puede ser también eficaz en la detección y re-estadificación de la enfermedad recurrente


Introduction. Gastrointestinal stromal tumors (GISTs) account for almost 4 % of all gastrointestinal neoplasms. Recently, a new type of tyrosine kinasa inhibitor (Glivec), has been successfully used in patients with metastasic or unresectable disease. The aim of the study is to show the utility of PET in the staging, recurrence and treatment response to Glivec in GIST tumors. Materials and methods. 48 whole body FDG-PET studies in 27 patients with GIST (19 men/mean age = 56 y) were evaluated for initial staging (n = 13), recurrence (n = 15) or treatment response to Glivec (n = 20). Images were acquired in a whole body 2D mode using attenuation correction on an Advance Nxi G.E.MS camera and were evaluated visually and quantatively using SUV analysis. Results were compared with radiological findings, hystological confirmation or follow-up. Results. In the initial staging evaluation, FDG-PET shows a more extensive disease than suspected in 3/10 patients. In other 3 patients PET ruled out mesenteric or peritoneal disease. In the evaluation of treatment response to Glivec, FDG-PET showed a good response in eleven patients (complete response in seven and partial response in four). In this group a sixty percent decrease of the SUV max was assessed. Two patients show not response to Glivec at doses of 400 mg neither 800 mg, showing an stable SUV value and/or increased in some abdominal lesions. PET detected recurrence in one patient. Conclusions. This study show how FDG-PET is accurate in the early treatment response to Glivec. PET could be helpful in the staging and recurrence of GIST tumors


Subject(s)
Adult , Aged , Middle Aged , Humans , Antineoplastic Agents/therapeutic use , Piperazines/therapeutic use , Pyrimidines/therapeutic use , Drug Resistance, Neoplasm , Stomach Neoplasms , Neoplasm Metastasis , Neoplasm Recurrence, Local , Neoplasm Staging/methods
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