Comparison of the Diagnostic Ability of Endoscopic Ultrasonography and Abdominopelvic Computed Tomography in the Diagnosis of Gastric Subepithelial Tumors

Abstract

Background/AimsEndoscopic ultrasonography (EUS) is the most efficient imaging modality for gastric subepithelial tumors (SETs). However, abdominopelvic computed tomography (APCT) has other advantages in evaluating the characteristics, local extension, or invasion of SETs to adjacent organs. This study aimed to compare the diagnostic ability of EUS and APCT based on surgical histopathology results. MethodsWe retrospectively reviewed data from 53 patients who underwent both EUS and APCT before laparoscopic wedge resection for gastric SETs from January 2010 to December 2017 at a single institution. On the basis of histopathology results, we assessed the diagnostic ability of the 2 tests. ResultsThe overall accuracy of EUS and APCT was 64.2% and 50.9%, respectively. In particular, the accuracy of EUS vs. APCT for the diagnosis of gastrointestinal stromal tumors (GISTs), leiomyomas, and ectopic pancreas was 83.9% vs. 74.2%, 37.5% vs. 0.0%, and 57.1% vs. 14.3%, respectively. Most of the incorrect diagnoses with EUS involved hypoechoic lesions originating in the fourth echolayer, with the most common misdiagnosed lesions being GISTs mistaken for leiomyomas and vice versa. ConclusionsAPCT showed a lower overall accuracy than EUS; however, APCT remains a useful modality for malignant/potentially malignant gastric SETs.

A Nomogram for Predicting Laparoscopic and Endoscopic Cooperative Surgery during the Endoscopic Resection of Subepithelial Tumors of the Upper Gastrointestinal Tract

“…The most common location of malignant/potentially malignant SETs was the gastric body (78.1%), followed by the fundus (15.6%). In particular, GISTs were frequently found in the gastric body (25/31, 80.6%) and fundus (4/31, 12.9%) [16]. In our analysis, GISTs were mostly found at the gastric fundus.…”

Advancements in the Diagnosis of Gastric Subepithelial Tumors

“…A retrospective analysis in 53 SETs reveals that overall accuracy of CT in histology is 50.9%: 74.2% in GISTs, 0% in leiomyoma, and 14.3% in ectopic pancreas, each of which is lower than that of EUS. 12 Consequently, CT is useful to obtain general information on lesions and surrounding circumstances as well as the metastases/invasion, however, that is less helpful, particularly in small lesions and suggests equivocal diagnosis in histology.…”

Ultrasonido endoscópico, aplicaciones actuales en tumores sólidos gastrointestinales

“…Otro cambio en la 8.ª edición de TNM es la separación de los tumores T1 en tumores T1a y T1b. Esta diferenciación es importante porque el riesgo de metástasis ganglionares aumenta del 3 % al 6 % para los tumores de la mucosa T1a, al 21,24 % para los tumores submucosos T1b (11). Esta diferenciación de los tumores T1 es importante para guiar las decisiones sobre el tratamiento endoscópico frente al quirúrgico (12) y, en este escenario, el papel del USE es fundamental.…”