GISTs — Gastrointestinal Stromal Tumors by Elisabetta Lutio di Castelguidone & Antonella Messina

GISTs — Gastrointestinal Stromal Tumors by Elisabetta Lutio di Castelguidone & Antonella Messina

Author:Elisabetta Lutio di Castelguidone & Antonella Messina
Language: eng
Format: epub
Publisher: Springer Milan, Milano


(6)Department of Radiology and Radiotherapy, National Cancer Institute, Milan, Italy

Abstract

Diagnostic imaging provides a valuable contribution to the study of primary and metastatic gastrointestinal stromal tumors (GISTs) with Magnetic Resonance (MR). MR can be used In the Identification, characterization and staging of GISTs, as well as In the evaluation of response to treatment, showing the tissue changes Induced In cancer cells by molecular targeted therapies, Including myxohyaline changes, fibrosis, hemorrhagic necrosis and cellularity reduction. Tumor response to medical treatment has to date been evaluated by size criteria (RECIST). However, In the case of GISTs, size criteria alone cannot provide an objective evaluation of response: In the early months of treatment a “paradoxic”response In relation to tumor size may occur, with stable or even Increased size of the tumor due to hemorrhage-necrosis or myxohyaline degeneration. MR Is able to assess the vascular patterns of neoplastic lesions and to quantify the reduction In vascularity and the presence of necrosis Induced by the therapy, even In the early phase of treatment.

MR Is an effective examination technique In the evaluation of GISTs, with highcontrast resolution and multlplanar capability. The most effective examination techniques are morphologic T1w and T2w sequences, combined with dynamic ce T1w sequences, to evaluate the vascular patterns of the lesions.



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