Preoperative prediction of gastrointestinal stromal tumors with high Ki-67 proliferation index based on CT features

Abstract

Background: To determine whether preoperative computed tomography (CT) features can be used for the prediction of gastrointestinal stromal tumors (GISTs) with a high Ki-67 proliferation index (Ki-67 PI).Methods: A total of 198 patients with surgically and pathologically proven GISTs were retrospectively included. All GISTs were divided into a low Ki-67 PI group (<10%) and a high Ki-67 PI group (≥10%). All imaging features were blindly interpreted by two radiologists. Receiver operating characteristic (ROC) curve analyses were conducted to evaluate the predictive performance of the imaging features.Results: Imaging features were found to be significantly different between the low and the high Ki-67 PI groups (P<0.05). Wall thickness of necrosis showed the highest predictive ability, with an area under the curve (AUC) of 0.838 [95% confidence interval (CI): 0.627-0.957], followed by necrosis, necrosis degree, hyperenhancement of the overlying mucosa (HYOM), and long diameter (LD) (AUC >0.7, P<0.05). HYOM was the strongest predictive feature for the high Ki-67 PI GISTs group, with an odds ratio (OR) value of 30.037 (95% CI: 5.707-158.106).Conclusions: Imaging features, including the presence of necrosis, high necrosis degree, thick wall of necrosis, and HYOM were significant predictive indicators for the high Ki-67 PI GISTs group.

Early Prediction and Monitoring of Treatment Response in Gastrointestinal Stromal Tumors by Means of Imaging: A Systematic Review

“…Other excluded articles discussed the efficacy of a specific TKI treatment but did not quantify the efficacy of imaging features in predicting or monitoring response [ 22 , 23 ]. Of the 90 eligible articles, 67 were concerning response prediction [ 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , ...…”

“…The changes in enhancement patterns were attributed to the principle of neovascularization. Tumors with high proliferative activity can induce the formation of hyperpermeable disorganized blood vessels and consequent development of necrosis [ 29 , 61 ]. Therefore, the supply and washout of contrast agent is affected, which has a direct impact on tumor enhancement patterns.…”

Selenylated Imidazo [1,2-a]pyridine Induces Apoptosis and Oxidative Stress in 2D and 3D Models of Colon Cancer Cells

“…Caco-2 and HT-29 were plated at a density of 5 × 10 5 cells/mL and incubated with MRK-107 at GI 50 or DGI 50 , a negative control solution, or DOX at 3.68 µM for 48 h. Cells were trypsinized and centrifuged. The supernatant was discarded, and cells received the addition of 100 µL of PBS with pre-diluted Ki-67 antibody [ 79 ]. Plates were incubated at 4 °C in the dark for 30 min and then centrifuged and washed with PBS.…”