Association between CT imaging features and KIT mutations in small intestinal gastrointestinal stromal tumors

Abstract

Small intestinal gastrointestinal stromal tumors (GISTs) have different clinical outcomes when KIT mutations are in exons 11 or 9, which are also the most common sites of neoplastic KIT mutations. The purpose of this study is to evaluate the CT imaging features in those two groups. A total of 35 patients were enrolled, and both quantitative and qualitative CT imaging features were compared between patient groups with KIT exon 9 mutations (KIT–9) and exon 11 mutations (KIT–11). The KIT–9 group was statistically associated with a tumor size larger than 10 cm and a higher enhancement ratio when compared with those of the KIT–11 group (both P < 0.05). For the enhancement ratio, the receiver operating characteristic curve indicated a cut-off value of 1.60 to differentiate KIT–9 from KIT–11 tumors. Additionally, tumor necrosis was more commonly seen in the KIT-9 group. In multivariate analysis, tumor size (β = 0.206; P = 0.022) and KIT–9 (β = 0.389; P = 0.006) were independent factors associated with tumor necrosis. Taken together, KIT–9 mutant tumors tended to have CT imaging features indicative of more aggressive neoplasms. These findings may be helpful in identifying more aggressive small intestinal GISTs and optimizing treatment.

Value of contrast-enhanced CT based radiomic machine learning algorithm in differentiating gastrointestinal stromal tumors with KIT exon 11 mutation: a two-center study

“…Various types of medical images can be analyzed to help with diagnosis and treatment and support traditional diagnostic methods (14,16,31,32). Considering that different mutation accompanied by different enhancement ratio, heterogeneous blood supply (33). Using VOIs extracted from tri-phase CE-CT images to construct a combined radiomics algorithm (11) can provide more representative information about a tumor when all available slices are considered (34), and may have better clinical application value and generalizability in discriminating mutation (34)(35)(36).…”

New advances in radiomics of gastrointestinal stromal tumors

“…Few data exist regarding the association between CT imaging features and mutations in GISTs[ 57 , 58 ]. The performance of radiomics features and radiologists visual analysis for the differentiation of GISTs with and without KIT exon 11 mutations have been explored by Xu et al[ 41 ] in a study cohort and validation group of 69 and 17 GISTs, respectively.…”

Current and Potential Applications of Artificial Intelligence in Gastrointestinal Stromal Tumor Imaging

“…In addition, GISTs with KIT exon 9 mutations are more responsive to sunitinib. The connection between CT findings and GISTs genotype has been investigated [ 48 ]. GISTs with KIT exon 9 mutation classification have significant linkages with tumor size more than 10 cm, a stronger enhancement grade and greater area of tumor necrosis when compared to those of the KIT exon 11 mutation classification ( P < 0.05).…”