Cystic changes in hepatic and peritoneal metastases from gastrointestinal stromal tumors treated with Gleevec

Abdom Imaging. 2003 Nov-Dec;28(6):808-14. doi: 10.1007/s00261-003-0021-2.


Background: Tyrosine kinase inhibitor (Gleevec or STI-571) must be considered the treatment of choice for metastatic gastrointestinal stromal tumors (GISTs). The purpose of this article is to address and illustrate a long-term follow-up of computed tomographic (CT) radiologic findings in patients with metastases from GIST after Gleevec treatment.

Methods: We performed a retrospective review of seven patients (four male, three female) with unresectable metastases from GIST who were treated with STI-571 in a 1-year period. Patients were followed every 2-4 months by contrast-enhanced CT for up to 12 months. The size and attenuation of hepatic and peritoneal metastases on CT were measured and correlated.

Results: Hepatic metastases from GISTs showed significant decreased attenuation from a mean of 60 HU to a mean of 32 HU (p < 0.01) in the first 2 months and continued decreasing attenuation to 23 HU at the 12-month follow-up. These metastases superficially resembled simple cysts. Most metastases became smaller, with more defined borders, after treatment. Histologic examination in a resected specimen revealed hepatic cyst with no residual tumor cells, regression of omental lesions, and extensive necrosis.

Conclusions: CT findings of unresectable hepatic and peritoneal metastases from GIST displayed decreasing, near cystic attenuation and size as an effective regression in response to STI-571 treatment.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Agents / therapeutic use*
  • Benzamides
  • Female
  • Follow-Up Studies
  • Gastrointestinal Neoplasms / pathology*
  • Humans
  • Imatinib Mesylate
  • Liver Neoplasms / drug therapy*
  • Liver Neoplasms / secondary*
  • Male
  • Middle Aged
  • Peritoneal Neoplasms / drug therapy*
  • Peritoneal Neoplasms / secondary*
  • Piperazines / therapeutic use*
  • Protein-Tyrosine Kinases / antagonists & inhibitors*
  • Pyrimidines / therapeutic use*
  • Retrospective Studies
  • Stromal Cells
  • Time Factors


  • Antineoplastic Agents
  • Benzamides
  • Piperazines
  • Pyrimidines
  • Imatinib Mesylate
  • Protein-Tyrosine Kinases