Imaging of gastrointestinal stromal tumour (GIST)

Lau, Stephanie H. Y.; Tam, KF; Kam, C.K.; Lui, CY; Siu, C.W.J.; Lam, H. S.; Mak, Kong Ling

doi:10.1016/j.crad.2003.10.018

Cited by 125 publications

(124 citation statements)

References 18 publications

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“…We evaluated the intratumoral heterogeneity of F-18 FDG uptake to discriminate them from other abdominal tumors for diagnosis. A previous study reported heterogeneous enhancement in large GISTs on enhanced CT [7]. Focal areas of low attenuation on CT in small GISTs represent varying pathological conditions, including solid tumor, hemorrhage, hemorrhage with necrosis, cystic degeneration, fluid in ulcers, and fibrous septum [8].…”

Section: Discussionmentioning

confidence: 94%

Intratumoral heterogeneity of F-18 FDG uptake differentiates between gastrointestinal stromal tumors and abdominal malignant lymphomas on PET/CT

et al. 2011

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Objective Gastrointestinal stromal tumors (GISTs) and malignant lymphomas (MLs) in the abdomen are often observed as tumors of unknown origin on F-18 FDG PET/ CT. The purpose of this study was to evaluate the intratumoral metabolic heterogeneity of F-18 FDG uptake on PET to determine if it might be helpful to discriminate between these tumors. Methods The F-18 FDG PET/CT findings of 21 large abdominal tumors were retrospectively evaluated (9 GISTs and 12 MLs). Intratumoral heterogeneity was evaluated by visual scoring (visual score: 0, homogeneous; 1, slightly heterogeneous; 2, moderately heterogeneous; 3, highly heterogeneous) and by the cumulative standardized uptake value (SUV) histograms on transaxial PET images at the maximal cross-sectional tumor diameter. Percent tumor areas above a threshold from 0 to 100% of the maximum SUV were plotted and the area under curve of the cumulative SUV histograms (AUC-CSH) was used as a heterogeneity index, where lower values corresponded with increased heterogeneity. Correlation between the visual score and the AUC-CSH was investigated by the Spearman's rank test. Results GISTs exhibited heterogeneous uptake of F-18 FDG, whereas MLs showed rather homogeneous uptake on visual analysis (visual score: 2.67 ± 0.50 and 0.58 ± 0.79, respectively; p \ 0.001). The AUC-CSH was significantly lower for the GISTs than for the MLs (0.41 ± 0.14 and 0.64 ± 0.08, respectively; p \ 0.001). Significant correlations were observed between the visual score and the AUC-CSH (q = -0.866, p \ 0.001). Conclusion GISTs exhibited significantly heterogeneous intratumoral tracer uptake as compared with the MLs. Evaluation of the intratumoral heterogeneity of F-18 FDG uptake may help in the discrimination between these tumors.

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Section: Discussionmentioning

confidence: 94%

Intratumoral heterogeneity of F-18 FDG uptake differentiates between gastrointestinal stromal tumors and abdominal malignant lymphomas on PET/CT

et al. 2011

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“…Presence of gas or contrast in the interior of the lesion can suggest presence of mucosa ulceration and fistula formation (18) . In our study, we found area of central hypodensity in 52.4% of the patients, mucosa ulceration in 52.4% and fistulas in 28.6%.…”

Section: Discussionmentioning

confidence: 99%

“…Computed tomography is the most important imaging modality in the characterization of the GIST, as well as in the evaluation of adjacent organs invasion, abdominal metastasis, and response to treatment (1,3,10) . Technological improvement of this method has allowed a better assessment of large exophytic tumors and the relations of the gastric lesion with adjacent structures, and allows the characterization of tumors in specific circumstances such as masses of unknown origin or originated from sites inaccessible to endoscopy (4,18) .…”

Section: Discussionmentioning

confidence: 99%

Tomographic Findings of Gastric Gastrointestinal Stromal Tumor and Correlation With the Mitotic Index

Pelandré

Djahjah

Gasparetto

et al. 2013

Arq. Gastroenterol.

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-Context -Gastrointestinal stromal tumors are uncommon abdominal neoplasms and can affect any portion of the gastrointestinal tract. Objectives -Describe the tomographic findings of the gastrointestinal stromal tumor of gastric origin, correlating it with the mitotic index. Methods -Twenty-one patients were selected within the period of January 2000 and 2008, with histopathological and immunohistochemical diagnosis of gastric gastrointestinal stromal tumors, who presented computed tomography done before the treatment. The tomographic variables analyzed were lesion topography, dimensions, contours, morphology, pattern and intensity enhancement through venous contrast, growth pattern, invasion of adjacent organs, presence of ulceration, fistula, calcifications, infiltration of mesenteric fat, lymphadenopathy and metastasis. The mitotic index was determined through optic microscopy, counting the number of mitosis figures in 50 high power fields. Results -The tumors were located in the body (66.7%) or gastric fundus (33.3%), with dimensions varying between 4.2 and 21.2 cm (average of 10.5 cm). The growth was predominantly extraluminal (47.6%) or intra/extra luminal (28.6%). The enhancement by venous contrast was heterogeneous in 66.7%. The statistical analysis showed that irregular morphology (P = 0.027) and infiltration of mesenteric fat (P = 0.012) presented correlation with the high mitotic index. Conclusions -In the present study, most part of the tumors were located in the gastric body, with average size of 10.5 cm, presenting central hypo dense area, heterogeneous enhancement through contrast and predominantly extra luminal growth. Irregular morphology and infiltration of mesenteric fat present statistical correlation with high mitotic level. HEADINGS -Gastrointestinal stromal tumors. Spiral computed tomography. Mitotic index.

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“…The clinical presentation depends on the site of the tumor and almost 20% of them may be asymptomatic. The diagnosis may be done by endoscopic exams, computed tomography or magnetic resonance of the abdomen (18,22) . Percutaneous biopsy can not be recommended in resectable tumors because the biopsy can precipitate tumor rupture, bleeding or dissemination.…”

Section: Introductionmentioning

confidence: 99%

Ki67 and p53 in gastrointestinal stromal tumors - GIST

Neves¹,

Oshima²,

Neto³

et al. 2009

Arq. Gastroenterol.

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-Context -Gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor. Cellular proliferation and apoptosis is gaining importance for predicting prognosis in several cancers. Objective -To investigate the Ki67 and p53 immunostaining in GISTs. Methods -Specimens from 40 patients with GIST were assessed for immunohistochemical expression of Ki67 and p53. The tumors were divided according the risk of recurrence in two groups: I with high or intermediate risk and; II with low or very low risk. Results -Among the 40 patients, 21 were men, the mean age was 56 years, 16 occurred in the small intestine and 13 in the stomach, 5 in the retroperitonium, 4 in the colon or rectum and 2 in the mesenterium. Thirty two tumors were from group I and 8 from group II. Half of the patients developed recurrence, being 90% of the group I (P = 0.114). The tumor Ki67 labelling index ranged from 0.02 to 0.35 (mean level 0.12). This index was marginally higher in the group I patients with recurrence (P = 0.09) compared to the patients of the same group without recurrence. p53 staining was expressed in 65% of the GISTs. A higher frequency of p53 and Ki67 had been found in the group I tumors when compared to the other group (P = 0.022; OR = 8.00 -IC 95%: 1.32-48.65). Conclusion -The most common site was the small intestine and 80% had a malignant potential justifying the high recurrence observed. No significant correlation was found between p53 and overall outcome of the patients. In group I patients, the evaluation Ki67LI may be a marker of prognosis. The positivity of both markers is higher among the patients with worst prognosis than in the others. HEADINGS -Gastrointestinal stromal tumors. Ki-67 antigen. Tumor suppressor protein p53.

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Imaging of gastrointestinal stromal tumour (GIST)

Cited by 125 publications

References 18 publications

Intratumoral heterogeneity of F-18 FDG uptake differentiates between gastrointestinal stromal tumors and abdominal malignant lymphomas on PET/CT

Intratumoral heterogeneity of F-18 FDG uptake differentiates between gastrointestinal stromal tumors and abdominal malignant lymphomas on PET/CT

Tomographic Findings of Gastric Gastrointestinal Stromal Tumor and Correlation With the Mitotic Index

Ki67 and p53 in gastrointestinal stromal tumors - GIST

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