PMC2409485_01
Response to imatinib treatment. Computed tomographic examination before imatinib treatment: a solitary liver metastasis (arrow) and multiple peritoneal metastases (arrowheads) (A), CT scan after 6 months of imatinib treatment showing a partial response (B), gadolinium-enhanced T1-weighted MRI after 9 months of imatinib treatment showing disease progression only in the liver metastatic deposit (arrow) (C), PET scan after 10 months of imatinib treatment. The increased uptake of the tracer [18F]FDG was seen only in the liver metastatic deposit (arrow) (D).
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At 11 months after initial resection, computed tomography (CT) revealed a solitary liver metastasis measuring 3.1 cm in diameter and multiple peritoneal metastases, of which the largest was 5.5 cm in diameter (Figure 1A). CT scans showed that the liver and peritoneal metastatic tumours had reduced in size to 2.5 and 3.4 cm in diameter, respectively. Computed tomography scans conducted a further 3 months later showed that the antitumour effect of imatinib had continued, confirming a partial response (PR) (Figure 1B). However, 9 months after imatinib treatment was initiated, CT and magnetic resonance imaging (MRI) revealed disease progression at the metastatic site in the liver (Figure 1C). Positron-emission tomography (PET) with [18F] fluorodeoxyglucose ([18F]FDG) as a tracer revealed increased uptake only in the liver metastasis (Figure 1D), suggesting that the liver tumour was active and insensitive to imatinib.