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影像学是评价胃肠间质瘤(gastrointestinal stromal tumor,GIST)靶向治疗疗效的主要手段。CT和MRI可方便、客观的反应GIST疗后改变,是目前临床应用最为广泛的影像学评估方法。靶向治疗有效的GIST病灶早期以出血、坏死、囊变及黏液变为主要表现,此时体积可能缩小不明显甚至增大,RECIST形态学标准应用受到限制。新近结合强化CT值变化率提出的Choi标准以及欧洲通过大样本随访研究制定的EORTC/ISG/AGITG联合标准,拓展了影像学对GIST靶向治疗疗效评价的理念。正电子发射断层显像(PET)及磁共振扩散加权功能成像可在更早期评价GIST靶向治疗疗效,有效组在初始治疗后1周内即可出现量化表征值的显著下降,成为GIST疗效评价及预测的潜力手段。
Imaging is the primary means of evaluating the efficacy of targeted therapy of gastrointestinal stromal tumor (GIST). CT and MRI can be convenient and objective response to GIST changes after treatment, is currently the most widely used imaging methods of imaging assessment. Targeted treatment of GIST lesions with early bleeding, necrosis, cystic and mucus become the main performance, then the volume may shrink is not obvious or even increased, RECIST morphological standard application is limited. The newly proposed Choi standard combined with the rate of change of CT value and the European EORTC / ISG / AGITG joint standard developed by large sample follow-up studies have expanded the concept of imaging evaluation of the efficacy of GIST targeted therapy. Positron emission tomography (PET) and diffusion weighted imaging of magnetic resonance diffusion-weighted imaging can evaluate the efficacy of targeted therapies for GIST at a much earlier stage, with a significant decrease in quantified values within 1 week of initial treatment in the effective group, a GIST efficacy evaluation And forecast the potential means.