Reproducible imaging features of biologically aggressive gastrointestinal stromal tumors of the small bowel

Purpose To identify reproducible CT imaging features of small bowel gastrointestinal stromal tumors (GIST) that are associated with biologic aggressiveness. Methods Patients with histologically proven small bowel GISTs and CT enterography or abdominopelvic CT were included. Biologic aggressiveness w...

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Bibliographic Details
Published in:Abdominal imaging 2018-07, Vol.43 (7), p.1567-1574
Main Authors: Maldonado, Francisco J., Sheedy, Shannon P., Iyer, Veena R., Hansel, Stephanie L., Bruining, David H., McCollough, Cynthia H., Harmsen, William S., Barlow, John M., Fletcher, Joel G.
Format: Article
Language:English
Subjects:
Ascites
Calcification
Computed tomography
Evaluation
Gangrene
Gastroenterology
Gastrointestinal cancer
Hepatology
Imaging
Liver
Medical imaging
Medicine
Medicine & Public Health
Metastases
Metastasis
Necrosis
Patients
Peritoneum
Radiology
Risk groups
Small intestine
Tumors
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Summary:Purpose To identify reproducible CT imaging features of small bowel gastrointestinal stromal tumors (GIST) that are associated with biologic aggressiveness. Methods Patients with histologically proven small bowel GISTs and CT enterography or abdominopelvic CT were included. Biologic aggressiveness was established based on initial histologic grading (very low risk to malignant), with “malignant” assigned if recurrence or metastases developed subsequently. CT exams were independently evaluated by three gastrointestinal radiologists for tumor size, growth pattern, enhancement, tumor borders, necrosis, calcification, ulceration, multiplicity, internal air or enteric contrast, nodal metastasis, liver metastasis, peritoneal metastasis, ascites, and draining vein size. Inter-observer variability and imaging features associated with high-grade and malignant small bowel GISTs were determined. Results Of 78 patients with small bowel GISTs, 10/78 (13%) were high grade and 18/78 (23%) were malignant. There was moderate to substantial inter-observer agreement (Kappa > 0.4) for all findings except tumor border, ulceration, and nodal metastases. Tumor size, irregular or invasive tumor border, necrosis, liver metastasis, ascites, and iso-enhancement were associated with high-grade/malignant small bowel GISTs ( p  
ISSN:2366-004X
2366-0058
DOI:10.1007/s00261-017-1370-6