Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Surgery Today
Published in: Surgery Today 10/2013

01-10-2013 | Original Article

The efficacy of PET-CT for predicting the malignant potential of gastrointestinal stromal tumors

Authors: Kozo Yoshikawa, Mitsuo Shimada, Nobuhiro Kurita, Hirohiko Sato, Takashi Iwata, Shinya Morimoto, Tomohiko Miyatani, Hideya Kashihara, Chie Takasu, Noriko Matsumoto

Published in: Surgery Today | Issue 10/2013

Login to get access

Abstract

Purposes

Gastrointestinal stromal tumor (GIST) is the most common sarcoma of the intestinal tract. The risk category is usually determined by tumor size and mitotic count, but accurate preoperative diagnosis of GIST is very difficult. The purpose of this study is to evaluate the efficacy of positron emission tomography (PET)-CT for predicting the malignant potential of gastrointestinal stromal tumors.

Methods

Ten patients with GIST who underwent a preoperative PET-CT examination were divided into two groups by risk category, and various factors were compared between the two groups. The relationships between the maximum standardized uptake value (SUVmax) and GIST parameters were examined.

Results

Patients were classified into two groups by their risk category: (low/intermediate-risk or high-risk). The SUVmax was significantly higher in the high-risk group (11.0 ± 3.04) than in the low/intermediate-risk group (2.1 ± 1.5). The Ki67 labeling index was also significantly higher in the high-risk group (8.63 ± 6.2) than in the low/intermediate-risk group (1.75 ± 0.52). There was a significant correlation between the Ki67 labeling index and the SUVmax (p = 0.028) and between the mitotic index and the SUVmax (p = 0.029).

Conclusions

PET-CT can predict malignant potential. Cases with a SUVmax of over 5 may have malignant potential.
Literature
1.
Kamiyama Y, Aihara R, Nakabayashi T. F-Fluorodeoxyglucose positron emission tomography: useful technique for predicting malignant potential of gastrointestinal stromal tumors. World J Surg. 2005;29:1429–35.PubMedCrossRef
2.
Eliseberg B, Jonathanharris MS. Phase II trial of neoadjuvant/adjuvant imatinib metastatic/recurrent operable gastrointestinal stromal tumor (GIST). J Surg Oncol. 2009;99:42–7.CrossRef
3.
John O, Montemurro M, Victoria M. Early prediction of response to sunitinib after imatinib failure by F-fluorodeoxyglucose positron emission tomography in patients with gastrointestinal stromal tumor. J Clin Oncol. 2008;27:439–45.CrossRef
4.
Haesun C, Chuslip C, Silvan C. Correlation of computed tomography and positron emission tomography in patients with metastatic gastrointestinal stromal tumor treated at a single institution with imatinib mesylate: proposal of new computed tomography response criteria. J Clin Oncol. 2007;25:1753–9.CrossRef
5.
Clay H, Holdsworth D, Badawi B. CT and PET: early prognostic indicators of response to imatinib mesylate in patients with gastrointestinal stromal tumor. AJR. 2007;189:324–30.CrossRef
6.
Patrick V, Valerie T, Klaus S. Feasibility of integrated CT-liver perfusion in routine FDG-PET/CT. Abdom Imaging. 2009;11:23–6.
7.
Isis G, Thuan V, Revathy I. The role of F-FDG PET in staging and early prediction ob response to therapy ob recurrent gastrointestinal stromal tumors. J Nucl Med. 2004;45:17–21.
8.
Ronald P, DeMatteo J, Lisa S. Tumor mitotic rate, size, and location independently predict recurrence after resection of primary gastrointestinal stromal tumor (GIST). Cancer. 2008;112:608–15.CrossRef
9.
Ando K, Sugiyama M, Zhao Y, Kojima A, Yamamoto H, Yamashita Y, et al. Secondary resistance of extra-gastrointestinal stromal tumors to imatinib mesylate. Surg Today. 2011;41:1290–3.PubMedCrossRef
10.
DeMatte RP, Maki RG, Samuel S, et al. Results of tyrosine kinase inhibitor therapy followed by surgical resection for metastatic gastrointestinal stromal tumor. Aun Surg. 2007;245:347–52.CrossRef
11.
Wong NA, Young R, Malcomson RDG, et al. Prognostic indicators for gastrointestinal stromal tumours: a clinicopathological and immunohistochemical study of 108 resected cases of the stomach. Histopathology. 2003;43:118–26.PubMedCrossRef
12.
Charles D, Cathryn R, Demetri DG, et al. Phase III randomized, intergroup trial assessing imatinib mesylate at two dose levels in patients with unresectable or metastatic gastrointestinal stromal tumors expressing the Kit receptor tyrosine kinase. J Clin Oncol. 2008;26:626–32.CrossRef
13.
Eisenberg BL, Jonathan H, Charles B. Phase II trial of neoadjuvant/adjuvant imatinib mesylate (IM) for advanced primary and metastatic/recurrent operable gastrointestinal stromal tumor (GIST)-early results of RTOG 0132. J Surg Oncol. 2009;1:42–7.CrossRef
14.
Blanke CD, Demetri GD, von Mehren M, et al. Long-term results from a randomized Phase II trial of standard-versus higher-dose imatinib mesylate for patients with unresectable or metastatic gastrointestinal stromal tumors expressing KIT. J Clin Oncol. 2008;26:620–5.PubMedCrossRef
15.
Fujimoto Y, Nakanishi Y, Yoshimura K. Clinicopathologic study of primary malignant gastrointestinal stromal tumor of the stomach, with special reference to prognostic factors: analysis of results in 140 surgically resected patients. Gastric Cancer. 2003;6:39–48.PubMedCrossRef
16.
Fletcher CD, Berman JJ, Corless C. Diagnosis of gastrointestinal stromal tumors: a consensus approach. Human Pathol. 2002;33:459–65.CrossRef
17.
Otsuka H, Terazawa K, Morita M. Is FDG-PET/CT useful for managing malignant pleural mesothelioma? J Med Invest. 2009;56:16–20.PubMedCrossRef
18.
Otsuka H, Morita N, Yamashita K. FDG-PET/CT findings of autoimmune pancreatitis associated with idiopathic retroperitoneal fibrosis. Ann Nucl Med. 2007;21:593–6.PubMedCrossRef
19.
20.
Wong R, Young R, Malcomson D. Prognostic indicators for gastrointestinal stromal tumours: a clinicopathological and immunohistochemical study of 108 resected cases of the stomach. Histopathology. 2003;43:118–26.PubMedCrossRef
21.
Burkill GJ, Badran M, Al-Muderis O. Malignant gastrointestinal stromal tumor: distribution, imaging features, and pattern of metastatic spread. Radiology. 2003;226:527–32.PubMedCrossRef
22.
Nishida T, Kumano S, Sugiura T. Multidetector CT of high-risk patients with occult gastrointestinal stromal tumors. AJR. 2003;180:185–9.PubMedCrossRef
23.
Demetri G. Identification and treatment of chemoresistant inoperable or meta-static GIST: experience with the selective tyrosine kinase inhibitor imatinib mesylate (ST1571). Eur J Cancer. 2002;38:52–9.CrossRef
24.
Demetri GD, von Mehren M, Blanke CD. Efficacy and safety of imatinib mesylate in advanced gastrointestinal stromal tumors. N Engl J Med. 2002;347:472–80.PubMedCrossRef
25.
Valk PE. Pounds by whole-body positron emission tomographic imaging. Ann Thorac Surg. 1995;60:1573–81.PubMedCrossRef
26.
Vitola JV, Delbeke D, Sandler MP. Positron emission tomography to stage suspected metastatic colorectal carcinoma to the liver. Am J Surg. 1996;171:21–6.PubMedCrossRef
27.
Otomi Y, Otsuka H, Morita N, Terazawa K, Furutani K, Harada M, et al. Relationship between FDG uptake and the pathological risk category in gastrointestinal stromal tumors. J Med Invest. 2010;57:270–4.PubMedCrossRef
28.
Park JW, Cho CH, Jeong DS, Chae HD. Role of F-fluoro-2-deoxyglucose positron emission tomography in gastric GIST. J Gastric Cancer. 2011;11:173–9.PubMedCrossRef
Metadata
Title
The efficacy of PET-CT for predicting the malignant potential of gastrointestinal stromal tumors
Authors
Kozo Yoshikawa
Mitsuo Shimada
Nobuhiro Kurita
Hirohiko Sato
Takashi Iwata
Shinya Morimoto
Tomohiko Miyatani
Hideya Kashihara
Chie Takasu
Noriko Matsumoto
Publication date
01-10-2013
Publisher
Springer Japan
Published in
Surgery Today / Issue 10/2013
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-012-0411-6

Other articles of this Issue 10/2013

Surgery Today 10/2013 Go to the issue

Case Report

Surgical treatment for an asymptomatic and unruptured sinus of Valsalva aneurysm: report of a case

Original Article

Factors influencing the outcome of image-guided percutaneous drainage of intra-abdominal abscess after gastrointestinal surgery

Original Article

Indications for emergency surgery for perforated diverticulitis in elderly Japanese patients ≥80 years of age

Case Report

Gallbladder herniation into the lesser sac through the foramen of Winslow: report of a case

Original Article

Polypropylene mesh repair of incarcerated and strangulated hernias: a prospective clinical study

Letter to the Editor

CAM 5.2 shows specific reactivity for cytokeratin 8, but less strict reactivity for cytokeratin 7 and no reactivity for cytokeratin 18: in response to “Fujikawa T, Tanaka A, Abe T et al. ‘Undifferentiated carcinoma of the common bile duct with intraductal tumor thrombi: report of a case’. Surg Today 2011;41(4):579–84.”