Computed tomography in gastrointestinal stromal tumors

Area of Science:

• Radiology
• Oncology
• Gastroenterology

Background:

• Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the gastrointestinal tract.
• Accurate characterization of GIST, including primary and recurrent forms, is crucial for effective management.
• Computed tomography (CT) is a primary imaging modality for evaluating GIST.

Purpose of the Study:

• To define the CT imaging characteristics of primary and recurrent GIST in relation to tumor size.
• To correlate imaging findings with tumor size, growth patterns, and signs of malignancy.

Main Methods:

• Retrospective analysis of CT scans from 35 patients with histologically confirmed GIST.
• Evaluation of morphologic characteristics including size, shape, homogeneity, density, enhancement, calcifications, ulcerations, fistulas, metastases, and organ infiltration.
• Comparison of imaging features between primary (n=20) and recurrent (n=16) tumors.

Main Results:

• Small GIST (<5 cm) typically show homogeneous density, sharp margins, and intraluminal growth.
• Intermediate GIST (>5-10 cm) present with irregular shape, inhomogeneous density, mixed intraluminal/extraluminal growth, and potential organ infiltration.
• Large GIST (>10 cm) and recurrent tumors display irregular margins, inhomogeneous density, aggressive findings, and signs of malignancy like distant metastases.

Conclusions:

• CT imaging features of GIST are significantly related to tumor size and stage (primary vs. recurrent).
• Larger tumor size and recurrent disease are associated with more aggressive imaging findings and signs of malignancy.
• CT is valuable for detecting and characterizing GIST, providing insights into tumor behavior and prognostic outcome.