Xiaoxuan Jia1, Yiting Liu2, Jiaqi Zhao1, Wanying Ji2, Lei Tang2, Zhidong Gao3, Liming Zhang4, Yinli Zhang5, Jian Li6, Nan Hong1, Yi Wang7, Yingshi Sun8. 1. Department of Radiology, Peking University People's Hospital, Beijing, 100044, China. 2. Department of Radiology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, 100142, China. 3. Department of Gastrointestinal Surgery, Peking University People's Hospital, Beijing, 100044, China. 4. Department of Gastroenterology, Peking University People's Hospital, Beijing, 100044, China. 5. Department of Pathology, Peking University People's Hospital, Beijing, 100044, China. 6. Department of Gastrointestinal Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, 100142, China. 7. Department of Radiology, Peking University People's Hospital, Beijing, 100044, China. Electronic address: wangyi@pkuph.edu.cn. 8. Department of Radiology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, 100142, China. Electronic address: sys27@163.com.
Abstract
PURPOSE: To investigate whether computed tomography (CT) could be used for screening and surveillance of small gastric gastrointestinal stromal tumors (gGISTs). METHOD: A total of 162 pathologically confirmed small gGISTs (≤2 cm) between September 2007 and November 2019 were retrospectively enrolled. Thirty-six lesions received contrast-enhanced CT after they were identified by endoscopy and EUS, and forty-three lesions received CT alone before surgery. The detection rate of CT for ≤1 cm gGISTs (micro-gGISTs) and 1-2 cm gGISTs (mini-gGISTs) was investigated, and the detection rate of CT alone was compared with that of CT following endoscopy and EUS. The relationship between EUS- and CT-detected high-risk features were assessed. RESULTS: CT demonstrated a favorable detection rate for mini-gGISTs previously identified by EUS and endoscopy, whereas CT alone showed an inferior detection rate (100 % vs. 75 %, p = 0.02). CT showed a poor detection rate for micro-gGISTs, both for lesions received CT after identified by EUS and endoscopy, and those received CT alone (33.3 % vs. 14.8 %, p = 0.372). CT-detected heterogeneous enhancement pattern and presence of calcification were strongly correlated with heterogeneous echotexture (Spearman's ρ=0.66, p < 0.001) and echogenic foci (Spearman's ρ=0.79, p < 0.001) on EUS, respectively. CT-detected necrosis was moderately correlated with cystic spaces on EUS (Spearman's ρ=0.42, p = 0.02). No correlation was found between EUS- and CT- assessed irregular border. CONCLUSIONS: CT could potentially be considered as a surrogate of EUS for surveillance of mini-gGISTs instead of micro-gGISTs, whereas couldn't be used as a screening modality for either micro- or mini-gGISTs.
PURPOSE: To investigate whether computed tomography (CT) could be used for screening and surveillance of small gastric gastrointestinal stromal tumors (gGISTs). METHOD: A total of 162 pathologically confirmed small gGISTs (≤2 cm) between September 2007 and November 2019 were retrospectively enrolled. Thirty-six lesions received contrast-enhanced CT after they were identified by endoscopy and EUS, and forty-three lesions received CT alone before surgery. The detection rate of CT for ≤1 cm gGISTs (micro-gGISTs) and 1-2 cm gGISTs (mini-gGISTs) was investigated, and the detection rate of CT alone was compared with that of CT following endoscopy and EUS. The relationship between EUS- and CT-detected high-risk features were assessed. RESULTS: CT demonstrated a favorable detection rate for mini-gGISTs previously identified by EUS and endoscopy, whereas CT alone showed an inferior detection rate (100 % vs. 75 %, p = 0.02). CT showed a poor detection rate for micro-gGISTs, both for lesions received CT after identified by EUS and endoscopy, and those received CT alone (33.3 % vs. 14.8 %, p = 0.372). CT-detected heterogeneous enhancement pattern and presence of calcification were strongly correlated with heterogeneous echotexture (Spearman's ρ=0.66, p < 0.001) and echogenic foci (Spearman's ρ=0.79, p < 0.001) on EUS, respectively. CT-detected necrosis was moderately correlated with cystic spaces on EUS (Spearman's ρ=0.42, p = 0.02). No correlation was found between EUS- and CT- assessed irregular border. CONCLUSIONS: CT could potentially be considered as a surrogate of EUS for surveillance of mini-gGISTs instead of micro-gGISTs, whereas couldn't be used as a screening modality for either micro- or mini-gGISTs.
Authors: José M García Santos; Juana M Plasencia Martínez; Pablo Fabuel Ortega; Marina Lozano Ros; María Carmen Sánchez Ayala; Gloria Pérez Hernández; Pedro Menchón Martínez Journal: Insights Imaging Date: 2021-01-04