Stefanelli Antonella, Treglia Giorgio, Mirk Paoletta, Muoio Barbara, Giordano Alessandro
Institute of Nuclear Medicine, Catholic University of the Sacred Heart, Largo Gemelli, 8, 00168 Rome, Italy.
ISRN Gastroenterol. 2011;2011:824892. doi: 10.5402/2011/824892. Epub 2011 Aug 14.
Aim. (18)F-fluorodeoxyglucose positron emission tomography ((18)F-FDG PET) is a powerful tool for staging and defining "good responders" to chemotherapy in tumor setting. Gastrointestinal stromal tumors (GISTs) are sarcoma involving gastrointestinal tract and may require a chemotherapy including imatinib, a tyrosine kinase inhibitor agent. Some GIST patients become refractory to imatinib; therefore, other tyrosine kinase inhibitors or concomitant chemotherapy may be considered for treatment. The aim of this paper is to assess if (18)F-FDG PET imaging is a useful tool to evaluate treatment response to new chemotherapies beyond imatinib for GIST patients. Methods. We performed a review of the literature about the role of (18)F-FDG PET in the evaluation of treatment response to new chemotherapies beyond imatinib for GIST patients. Results and Conclusions. (18)F-FDG PET seems to be able to assess therapy response earlier than computed tomography (CT) imaging in imatinib refractory GIST patients treated with other agents. However, a dual modality PET-CT imaging is recommendable to achieve a better detection of all lesions.
目的。(18)F-氟脱氧葡萄糖正电子发射断层扫描((18)F-FDG PET)是肿瘤分期及确定化疗“良好反应者”的有力工具。胃肠道间质瘤(GIST)是累及胃肠道的肉瘤,可能需要包括酪氨酸激酶抑制剂伊马替尼在内的化疗。一些GIST患者对伊马替尼产生耐药;因此,可考虑使用其他酪氨酸激酶抑制剂或联合化疗进行治疗。本文旨在评估(18)F-FDG PET成像是否是评估GIST患者对伊马替尼以外的新化疗方案治疗反应的有用工具。方法。我们对有关(18)F-FDG PET在评估GIST患者对伊马替尼以外的新化疗方案治疗反应中的作用的文献进行了综述。结果与结论。在用其他药物治疗的伊马替尼耐药GIST患者中,(18)F-FDG PET似乎比计算机断层扫描(CT)成像能更早地评估治疗反应。然而,推荐采用PET-CT双模态成像以更好地检测所有病变。