Gastrointestinal Stromal Tumors Treated with Imatinib Mesylate: Apparent Diffusion Coefficient in the Evaluation of Therapy Response in Patients

Tang, Lei; Zhang, Xiao-Peng; Sun, Ying‐Shi; Shen, Lin; Li, Jian; Qi, Liping; Cui, Yong

doi:10.1148/radiol.10100402

Cited by 50 publications

(57 citation statements)

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“…The contrast in the resulting images results from differing signal loss from hydrogen proton movement12. DWI has extensively been used in tumor grading34, early detection or differential diagnosis of benign and malignant tumors5678, distinguishing viable and necrotic tissues9101112, assessment of organ function13, prediction of pathologic outcomes1415, and evaluation of tumor response to therapies16171819.…”

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confidence: 99%

Applicable apparent diffusion coefficient of an orthotopic mouse model of gastric cancer by improved clinical MRI diffusion weighted imaging

Sun

Zhang

et al. 2014

Sci Rep

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In vivo imaging studies in animal models are hindered by variables that contribute to poor image quality and measurement reliability. As such we sought to improve the diffusion coefficient (ADC) of an orthotopic mouse model of gastric cancer in diffusion-weighted images (DWI) using alginate moulding and Ultrasonic coupling medium. BGC-823 human gastric cancer cells were subcutaneously injected into the abdomen of nude mice and 1 mm3 primary tumour was orthotopically transplanted. Alginate and coupling medium were applied to the mice and MRI (T2 and DWI) was performed for 6 weeks. Regions of interest (ROI) were drawn and liver and tumour ADC were evaluated. Using alginate moulding, the mean quality total score of DW imaging was 8.53; however, in control animals this value was 5.20 (p < 0.001). The coefficient of variation of ADC of liver in experimental and control groups were 0.071 and 0.270 (p < 0.001), respectively, suggesting this method may be helpful for DWI studies of important human diseases such as gastric cancer.

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confidence: 99%

Applicable apparent diffusion coefficient of an orthotopic mouse model of gastric cancer by improved clinical MRI diffusion weighted imaging

Sun

Zhang

et al. 2014

Sci Rep

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“…In previous clinical studies, ADC values derived from conventional DWMRI have been used to predict responders versus non-responders among GIST patients within one month after Imatinib treatment[8, 15, 16], where increasing ADC values correlated well with the standardized uptake value (SUV) in 18 F-FDG PET/CT[15, 16]. Higher ADC values of responders compared to non-responders may correlate to the extensive cystic or myxoid degeneration of GIST[8, 27, 28].…”

Section: Discussionmentioning

confidence: 99%

“…Additionally dose-dependent adverse effects associated with Imatinib have occurred in patients with metastatic or surgically unresectable GISTs[5]. In order to optimize individual patient care and to avoid ineffective treatment and unnecessary toxicity, several noninvasive imaging modalities have been used to evaluate GIST response to Imatinib[6–8]. …”

Section: Introductionmentioning

confidence: 99%

“…Diffusion-weighted magnetic resonance imaging (DWMRI) is a non-invasive and nonionizing radiation imaging method that can measure tissue water mobility changes in order to evaluate GIST response to Imatinib[8, 15, 16]. In conventional DWMRI, tissue water mobility can be quantified with the apparent diffusion coefficient (ADC), which is calculated as the slope of the logarithm signal decay on diffusion-weighted images acquired at two or three diffusion weightings (e.g.…”

Section: Introductionmentioning

confidence: 99%

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The Therapeutic Response of Gastrointestinal Stromal Tumors to Imatinib Treatment Assessed by Intravoxel Incoherent Motion Diffusion-Weighted Magnetic Resonance Imaging with Histopathological Correlation

et al. 2016

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PurposeTo exploit the intravoxel incoherent motion (IVIM) diffusion-weighted (DW) MRI when evaluating the therapeutic response of gastrointestinal stromal tumors (GIST) to Imatinib in a mouse model.Materials and MethodsMice with xenografts bearing cells from the GIST-T1 cell line were randomly divided into a treated group receiving Imatinib and a control group. DWMRI scans with 14 b-values (0–1500 s/mm2) were performed before and after treatment (days 1, 3 and 7). IVIM related parameters perfusion fractions (fp) and perfusion-related diffusion coefficients (D*) and the conventional apparent diffusion coefficients (ADC) were calculated by fitting the DWMRI signal decay. The mean changes from baseline to each post-treatment time point for each measurement (ΔADC, Δfp and ΔD*) were calculated. The differences of mean changes between the two groups were tested for statistical significance. Histopathological analyses including Ki-67, CD31, TUNEL and H&E were conducted in conjunction with the MRI scans.ResultsIncreases in ADC of the treated group were higher than those of the control group after treatment, whereas statistical significances were not observed. Compared to the control group, D* in the treated group decreased significantly (ΔD*treated = -41%, -49%, and -49% with P = 0.0001, 0.0001 and 0.0001), and fp increased significantly (Δfptreated = 79%, 82% and 110%, with P = 0.001, 0.0001 and P = 0.0007) on days 1, 3 and 7 after treatment. Histopathological analyses demonstrated different tumor tissue characteristics between the treated and control groups.ConclusionIVIM measurements may serve as more sensitive imaging biomarkers than ADC when assessing GIST response to Imatinib as early as one day after treatment.

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“…Sixty-one journal articles remained for systematic review including 24 original contributions that evaluated the diagnostic quality of PET [13,18] and MRI [19] in comparison with CT as well as by histological work-ups for PET [20] , CT [19,21,22] and MRI [19] . Methods to assess therapy response by different imaging modalities were explored by CT [6,2325] , PET [14,20,26,27] , PETþCT [8,1113,18,2830] and MRI [7,31,32] . Benjamin et al [33] performed the only validating study with regard to the modified CT criteria proposed by Choi et al [12] In view of this weak data situation, the consensus determined by this Working Group could not be evidence-based and, therefore, is primarily based on the experience of the panellists.…”

Section: Methodsmentioning

confidence: 99%

Consensus report on the radiological management of patients with gastrointestinal stromal tumours (GIST): recommendations of the German GIST Imaging Working Group

Kalkmann¹,

Zeile²,

Antoch³

et al. 2012

Cancer Imaging

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The aim was to reach consensus in imaging for staging and follow-up as well as for therapy response assessment in patients with gastrointestinal stromal tumours (GIST). The German GIST Imaging Working Group was formed by 9 radiologists engaged in assessing patients with GIST treated with targeted therapy. The following topics were discussed: indication and optimal acquisition techniques of computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET)/CT; tumour response assessment considering response criteria and measurement techniques on CT, MRI and PET/CT; result interpretation; staging interval and pitfalls. Contrastenhanced CT is the standard method for GIST imaging. MRI is the method of choice in case of liver-specific questions or contraindications to CT. PET/CT should be used for early response assessment or inconclusive results on morphologic imaging. All imaging techniques should be standardized allowing a reliable response assessment. Response has to be assessed with respect to lesion size, lesion density and appearance of new lesions. A critical issue is pseudoprogression due to myxoid degeneration or intratumoural haemorrhage. The management of patients with GIST receiving a targeted therapy requires a standardized algorithm for imaging and an appropriate response assessment with respect to changes in lesion size and density.

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Gastrointestinal Stromal Tumors Treated with Imatinib Mesylate: Apparent Diffusion Coefficient in the Evaluation of Therapy Response in Patients

Abstract: Comparatively low pretherapy ADC and marked ADC increase at 1 week after therapy is associated with good response to imatinib mesylate in patients with GISTs.

Cited by 50 publications

References 36 publications

Applicable apparent diffusion coefficient of an orthotopic mouse model of gastric cancer by improved clinical MRI diffusion weighted imaging

Applicable apparent diffusion coefficient of an orthotopic mouse model of gastric cancer by improved clinical MRI diffusion weighted imaging

The Therapeutic Response of Gastrointestinal Stromal Tumors to Imatinib Treatment Assessed by Intravoxel Incoherent Motion Diffusion-Weighted Magnetic Resonance Imaging with Histopathological Correlation

Consensus report on the radiological management of patients with gastrointestinal stromal tumours (GIST): recommendations of the German GIST Imaging Working Group

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