TITLE:
Gastrointestinal Stromal Tumors: Correlation of Multislice CT Findings to Histopathologic Features and Preliminary Validation of New Scoring System
AUTHORS:
Leila Mchirgui, Rabii Noomene, Chiraz Jemli Chammakhi, Mohammed Habib Daghfous
KEYWORDS:
Gastrointestinal Stromal Tumors, Multi-Slice Computed Tomography, Pathology, Prognosis
JOURNAL NAME:
Open Journal of Radiology,
Vol.6 No.1,
March
23,
2016
ABSTRACT: Purpose: The purpose of this study is to demonstrate the correlation between radiologic and pathologic features of the gastrointestinal stromal tumors. Patients and methods: A retrospective review from 2004 to 2014 identified 50 resected cases of confirmed gastrointestinal stromal tumors (GIST) is done. All these lesions were visualized in the first multi-slice computed tomography (MSCT) investigation. Radiologic and pathologic features were reviewed and compared. A radiologic score with MSCT findings was established. Four levels of risk were defined and compared to the Miettinen-Lasota prognostic classification. Results: Mean patients’ age was 57.6 with a sex-ratio (M/F) of 1.17. Of the 50 GISTs lesions, 29 were located in the stomach (58%), 3 in the duodenum (6%), 16 in the small intestine (32%), one in the rectum and one in the great omentum. MSCT images were evaluated for origin and size of the tumor, as well as growth pattern, density before and after contrast, relationship with adjacent structures, presence of lymph nodes, ascitis and metastasis. The presence of mucosal ulceration, calcification, necrosis, cystic area or hemorrhage into the lesion was emphasized for each case. The histologic equivalent criteria were gathered from histopathology examination review of all specimens. Significant correlation was found for all these findings except the hemorrhage (p = 0.071). A radiologic score of fifteen items variable between 0 and 18 was established. Miettinen risk classification was noted for each lesion. GISTs with very low risk had MSCT score