shu-508 and Gastrointestinal-Stromal-Tumors

The early and functional evaluation of new treatments in oncology is a main goal. At present, technical advances in Doppler ultrasonography allow the detection of neovascularization for superficial and deep malignant tumours in order to evaluate the efficiency of new treatments such as antiangiogenic molecules. Contrast agents injection improves the efficiency of this technique and developments of perfusion softwares optimize this detection. Slow flows in tumour microvessels can be detected. Treatment response can be early predicted based on changes in the vascularization before volume modification. The availability of quantification softwares operating from the raw data before their compression for video display affords one and objective quantification of the contrast agent uptake.

Topics: Antineoplastic Agents; Benzamides; Contrast Media; Gastrointestinal Stromal Tumors; Humans; Imatinib Mesylate; Kidney Neoplasms; Microcirculation; Neoplasms; Neovascularization, Pathologic; Phospholipids; Piperazines; Polysaccharides; Pyrimidines; Sulfur Hexafluoride; Treatment Outcome; Ultrasonography

The purpose of this study was to evaluate contrast-enhanced Doppler sonography with perfusion software as a predictor of early tumor response to imatinib (Glivec) in c-kit-positive gastrointestinal stromal tumors (GISTs).. Thirty patients (59 tumors) with metastases or a recurrence from a GIST were prospectively included in a single-center imaging trial. Contrast-enhanced Doppler sonography was performed with an Aplio scanner the day before (day-1) starting oral treatment (400 mg) and at days 1, 7, 14, 60, 90, and 6 months, 9 months, and 1 year. The percentage of contrast uptake (Levovist or Sonovue) before treatment and at the different stages of follow-up was evaluated by two radiologists. Digitized quantification was performed using Photoshop software. To define the benchmark standard, all patients were rated as responders or nonresponders at 2 and 6 months by a board consisting of oncologists and radiologists who had all clinical and imaging data at their disposal. Changes in the percentage of contrast uptake at each sonographic examination were compared statistically.. A total of 185 examinations were performed. Forty-four lesions in 24 patients were completely evaluated at 2 months, and 29 lesions in 15 patients were completely evaluated at 6 months. Initial contrast uptake at day 1 was predictive of the future response. A strong correlation was found between the decline in tumor contrast uptake at days 7 and 14 and tumor response (p < 10(-4)).. Contrast-enhanced Doppler sonography is a noninvasive imaging technique that allows the early prediction of tumor response in c-kit-positive GIST treated with Glivec.

Topics: Antineoplastic Agents; Benzamides; Contrast Media; Female; Gastrointestinal Stromal Tumors; Humans; Imatinib Mesylate; Liver Neoplasms; Male; Middle Aged; Neoplasm Recurrence, Local; Phospholipids; Piperazines; Polysaccharides; Prognosis; Protein Kinase Inhibitors; Protein-Tyrosine Kinases; Proto-Oncogene Proteins c-kit; Pyrimidines; Sulfur Hexafluoride; Ultrasonography, Doppler

Recently, contrast agents for ultrasonography (US) such as Levovist have been introduced for routine clinical use. The contrast-enhanced US with Levovist permits evaluation of the intratumoral vascularity of hepatic and pancreatic tumors and is useful for their differential diagnosis. The purpose of the present study was to assess tumor vessels and the parenchymal flow of gastrointestinal stromal tumors (GISTs) by contrast-enhanced coded phase-inversion harmonic US and to evaluate whether vascularity is related to the malignant grade of the GISTs.. Thirteen patients with GISTs were included in the present study. Tumors were observed in a real-time fashion of contrast-enhanced coded phase-inversion harmonic US after the injection of Levovist (400 mg/ml). The vascular patterns were compared with tumor size, histological diagnosis, KIT mutations, and clinical findings such as metastasis.. The contrast-enhanced US images of the GISTs were classified into two types according to the blood flow area of the tumors as seen by real-time continuous imaging of the tumor vessels. The image pattern "Poor" represented vessels flowing only in the peripheral part of the tumor, and "Rich" represented abundant vessels flowing from the periphery to the central part of the tumor. According to the contrast-enhanced US images, five GISTs were classified as "Poor" and the others as "Rich." Based on the final diagnosis, all tumors with "Poor" images were determined to be benign GISTs, and the rest tumors except one with "Rich" images were determined to be malignant GISTs.. Contrast-enhanced US image is more closely correlated with the final diagnosis than the histological findings.

Topics: Blood Flow Velocity; Contrast Media; DNA, Neoplasm; Female; Gastrointestinal Stromal Tumors; History, 17th Century; History, 18th Century; Humans; Infant, Newborn; Injections, Intravenous; Intestinal Mucosa; Male; Microbubbles; Mutation; Neoplasm Staging; Neovascularization, Pathologic; Polymerase Chain Reaction; Polysaccharides; Proto-Oncogene Proteins c-kit; Retrospective Studies; Severity of Illness Index; Ultrasonography