title: Consensus report on the radiological management of patients with gastrointestinal stromal tumours (GIST): recommendations of the German GIST Imaging Working Group.
abstract: 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. Contrast-enhanced 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.
authors.affiliation: Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University Duisburg-Essen, Hufelandstrasse 55, 45122 Essen, Germany.
authors.forename: Janine
authors.initials: J
authors.lastname: Kalkmann
authors.forename: Martin
authors.initials: M
authors.lastname: Zeile
authors.forename: Gerald
authors.initials: G
authors.lastname: Antoch
authors.forename: Frank
authors.initials: F
authors.lastname: Berger
authors.forename: Stefan
authors.initials: S
authors.lastname: Diederich
authors.forename: Dietmar
authors.initials: D
authors.lastname: Dinter
authors.forename: Christian
authors.initials: C
authors.lastname: Fink
authors.forename: Rolf
authors.initials: R
authors.lastname: Janka
authors.forename: Jörg
authors.initials: J
authors.lastname: Stattaus
mesh_terms: D000465:Algorithms; D016477:Artifacts; D000075202:Contraindications; D003287:Contrast Media; D005500:Follow-Up Studies; D005770:Gastrointestinal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D046152:Gastrointestinal Stromal Tumors / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000556:secondary; D008279:Magnetic Resonance Imaging / Q000379:methods / Q000592:standards*; D064847:Multimodal Imaging / Q000379:methods / Q000592:standards*; D009367:Neoplasm Staging / Q000379:methods / Q000592:standards; D010386:Pelvic Neoplasms / Q000473:pathology / Q000556:secondary; D049268:Positron-Emission Tomography; D014057:Tomography, X-Ray Computed / Q000379:methods / Q000592:standards*
chemical_list: D003287:Contrast Media