Gastrointestinal Stromal Tumors: Correlation of Multislice CT Findings to Histopathologic Features and Preliminary Validation of New Scoring System

Abstract

Purpose: The purpose of this study is to demonstrate the correlation between radiologic and pathologic features of the gastrointestinal stromal tumors. Patients and methods: A retrospective review from 2004 to 2014 identified 50 resected cases of confirmed gastrointestinal stromal tumors (GIST) is done. All these lesions were visualized in the first multi-slice computed tomography (MSCT) investigation. Radiologic and pathologic features were reviewed and compared. A radiologic score with MSCT findings was established. Four levels of risk were defined and compared to the Miettinen-Lasota prognostic classification. Results: Mean patients' age was 57.6 with a sexratio (M/F) of 1.17. Of the 50 GISTs lesions, 29 were located in the stomach (58%), 3 in the duodenum (6%), 16 in the small intestine (32%), one in the rectum and one in the great omentum. MSCT images were evaluated for origin and size of the tumor, as well as growth pattern, density before and after contrast, relationship with adjacent structures, presence of lymph nodes, ascitis and metastasis. The presence of mucosal ulceration, calcification, necrosis, cystic area or hemorrhage into the lesion was emphasized for each case. The histologic equivalent criteria were gathered from histopathology examination review of all specimens. Significant correlation was found for all these findings except the hemorrhage (p = 0.071). A radiologic score of fifteen items variable between 0 and 18 was established. Miettinen risk classification was noted for each lesion. GISTs with very low risk had MSCT score < 4. GIST with low risk had a MSCT score between 5 and 9. GIST with moderate risk had a score between 10 and 14 and those with high risk had an MSCT score between 15 and 18. Significant correlation was found between the radiologic and histopathologic risk classification (p = 0. 001). Conclusion: MSCT is helpful in risk prediction for GIST.

Submucosal gastric lesions: a CECT-based tool for differential diagnosis between gastrointestinal stromal tumor and leiomyoma

“…Our study has demonstrated that 89.5% of leiomyomas were located either in the cardioesophageal junction or the cardiac section of the stomach, which does not contradict the earlier findings in the literature and can be explained by close location to the esophagus, which is the most frequent localization site for leiomyomas [7]. In contrast to that, the most common localization site for GISTs is stomach, which also consistent with other studies [8,9].…”

“…Напротив, наиболее распространенной локализацией ГИСО является тело желудка, что также согласуется с результатами других исследований [8,9].…”

CT Scan as A Diagnostic Modality of Gastrointestinal Stromal Tumor: A Systematic Review

“…11 To date, diagnosis of GIST is established by imaging as surgical biopsy for specimen carries on the risk of tumor rupture and tumor seeding along the tract of biopsy. 12 CT scan is reported to have a superiority in differentiating GIST to non-GIST as CT provides accurate tumor size, location, and tumor heterogeneity. 13 There's a group of experts believed that the accuracy of CT scan to be superior in diagnosing GIST, while as in contrast others recommend other modalities.…”