Evaluation of risk classifications for gastrointestinal stromal tumor using multi-parameter Magnetic Resonance analysis

Zheng, Tao; Du, Juan; Yang, Linsha; Dong, Yanchao; Wang, Zhanqiu; Liu, Defeng; Wu, Shuo; Shi, Qinglei; Wang, Xiaohan; Liu, Lanxiang

doi:10.1007/s00261-020-02813-y

Cited by 9 publications

(4 citation statements)

References 29 publications

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“…On MRI, GISTs typically show low signal intensity on T1-weighted and high signal intensity on T2-weighted sequences, and enhanced signal intensity on post gadolinium images, especially in the arterial phase [26]. MRI provides morphological imaging findings similar to those obtained from a CT scan; additionally, quantitative parameters such as the apparent diffusion coefficient (ADC) and degree of enhancement, and perfusion parameters are helpful in assessing the malignancy and response to treatment [27][28][29][30][31]. FDG PET is more sensitive than morphological imaging in evaluating therapy response [22].…”

Section: Discussionmentioning

confidence: 99%

Urgent Rare Surgical Complication Assessment of Intestinal Gastrointestinal Stromal Tumors

Picchi,

Lassandro,

Mazzotta

et al. 2024

JEVTM

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Gastrointestinal stromal tumors (GISTs) are rare mesenchymal subepithelial tumors originating from abnormal proliferation of interstitial cells of Cajal, with worldwide incidence of about 1–2 per 100,000. Herein, we report an unusual case of a 55-year-old man who presented a severe digestive hemorrhage as a rare post-surgical complication after intestinal GIST surgical removal. The patient was admitted to the Emergency Department of our center affected by abdominal epigastric pain. Different imaging techniques were performed leading to the final diagnosis of a GIST and surgical intervention planning. Immediately after intervention the patient developed a severe intestinal hemorrhage. Multidetector computed tomography (MDCT) confirmed the ongoing bleeding and the patient underwent a new intervention to control the hemorrhage. The aim of the paper is to show the different imaging techniques used to assess GIST. MDCT represents the gold standard for diagnosis and in the emergency setting is used to identify post-surgical complications.

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Section: Discussionmentioning

confidence: 99%

Urgent Rare Surgical Complication Assessment of Intestinal Gastrointestinal Stromal Tumors

Picchi,

Lassandro,

Mazzotta

et al. 2024

JEVTM

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“…EUS can detect submucosal neoplastic lesions well, but it is hard to judge subserosa, deep abdominal lesions and their surrounding conditions. Preoperative contrast-enhanced CT may be helpful in predicting pathologic risk categories of GISTs and multi-parameter MR analysis provides a preoperative imaging standard for accurately distinguishing very low-to-low-risk GIST from intermediate-to-high-risk GIST, which was reported by Grazzini et al (9) and Zheng et al (10) respectively. However, they are relatively complex and do not form a universally applicable standard.…”

Section: Introductionmentioning

confidence: 91%

Value of 18F-FDG PET/CT for differentiating diagnosis between malignant and benign primary gastric gastrointestinal mesenchymal tumors: a single-center retrospective study

Li¹,

Lin²,

Tang³

et al. 2022

J Gastrointest Oncol

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Background: Malignant primary gastric gastrointestinal stromal tumors (gGISTs) without treatment with imatinib are prone to bleeding and peritoneum implantation during operation. Therefore, preoperative assessment of the malignant potential of gGIST is essential. The use of 18 F-fluorodeoxyglucose ( 18 F-FDG) positron emission tomography (PET) combined with computed tomography (PET/CT) as a non-invasive tool for diagnosis, staging and prognosis evaluation in oncology, may also be useful for gGISTs. In the present study, we analyzed the value of 18 F-FDG PET-CT in assessing the malignant potential of gGISTs before treatment.Methods: Patients who were diagnosed with gGIST by pathology and underwent 18 F-FDG PET/CT at the same time were collected. The clinicopathological features of 26 patients with gGISTs were retrospectively analyzed at last. The gGIST risk classification was graded according to the US National Institutes of Health (NIH) GIST risk classification criteria [2008]. Lesions were classified as malignant group (moderate-or high-risk category) and benign group (low-or very low-risk category) according to pathology. The relationship between the maximal standard uptake value (SUVmax) and GIST risk category, tumor diameter, Ki-67 index, and mitotic count was analyzed. The cut-off level of SUVmax for the diagnosis of malignant gGIST with the highest sensitivity was calculated based on the receiver-operating characteristic (ROC) curve. Results:The SUVmax, tumor diameter, Ki-67 index, and mitotic count of the 26 gGIST patients were 5. 90±4.49, 7.40±4.92 cm, 7.62%±11.76%, (5.96±3.19)/50 high-power field (HPF), respectively. SUVmax was significantly correlated with GIST risk category, Ki-67 index, and mitotic count (r=0.855, 0.860, and 0.690, all P<0.01) but not with tumor diameter (r=0.383, P=0.054). The SUVmax of gGIST was 7.00±4.57 in the malignant group (moderate or high NIH risk category in 20 patients), which was significantly different from that (2.25±0.77) in the benign group (low or extremely low NIH risk category in 6 patients) (t=4.566, P<0.01). ROC curve analysis showed that a SUVmax cut-off of 2.60 was most sensitive for predicting malignant gGIST. When the area under the curve was 0.967, the sensitivity was 100% and the specificity was 83.3%.Conclusions: SUVmax may be used as a complementary indicator for predicting the malignant potential of gGISTs before treatment.

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“…On magnetic resonance imaging (MRI), GISTs typically show low signal intensity on T1-weighted imaging (T1WI), high signal intensity on T2WI, and enhanced signal intensity on post gadolinium images [33]. MRI generally provides morphological imaging findings similar to those obtained from CT; additionally, quantitative parameters, such as the apparent diffusion coefficient (ADC) and degree of enhancement, and perfusion parameters, are helpful in assessing malignancy and response to treatment, respectively [34][35][36][37]. MRI has advantages in diagnosing hepatic metastasis; a previous study reported that MRI detected additional hepatic metastasis, which was not detected via CT [38].…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

Gastrointestinal stromal tumors: a comprehensive radiological review

Inoue

Ota²,

Yamasaki

et al. 2022

Jpn J Radiol

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Gastrointestinal stromal tumors (GISTs) originating from the interstitial cells of Cajal in the muscularis propria are the most common mesenchymal tumor of the gastrointestinal tract. Multiple modalities, including computed tomography (CT), magnetic resonance imaging (MRI), fluorodeoxyglucose positron emission tomography, ultrasonography, digital subtraction angiography, and endoscopy, have been performed to evaluate GISTs. CT is most frequently used for diagnosis, staging, surveillance, and response monitoring during molecularly targeted therapy in clinical practice. The diagnosis of GISTs is sometimes challenging because of the diverse imaging findings, such as anatomical location (esophagus, stomach, duodenum, small bowel, colorectum, appendix, and peritoneum), growth pattern, and enhancement pattern as well as the presence of necrosis, calcification, ulceration, early venous return, and metastasis. Imaging findings of GISTs treated with antineoplastic agents are quite different from those of other neoplasms (e.g. adenocarcinomas) because only subtle changes in size are seen even in responsive lesions. Furthermore, the recurrence pattern of GISTs is different from that of other neoplasms. This review discusses the advantages and disadvantages of each imaging modality, describes imaging findings obtained before and after treatment, presents a few cases of complicated GISTs, and discusses recent investigations performed using CT and MRI to predict histological risk grade, gene mutations, and patient outcomes.

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Evaluation of risk classifications for gastrointestinal stromal tumor using multi-parameter Magnetic Resonance analysis

Cited by 9 publications

References 29 publications

Urgent Rare Surgical Complication Assessment of Intestinal Gastrointestinal Stromal Tumors

Urgent Rare Surgical Complication Assessment of Intestinal Gastrointestinal Stromal Tumors

Value of 18F-FDG PET/CT for differentiating diagnosis between malignant and benign primary gastric gastrointestinal mesenchymal tumors: a single-center retrospective study

Gastrointestinal stromal tumors: a comprehensive radiological review

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