Gastrointestinal stromal tumor CT: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
 
(12 intermediate revisions by 3 users not shown)
Line 1: Line 1:
__NOTOC__
__NOTOC__
{{Gastrointestinal stromal tumor}}
{{CMG}}{{AE}}{{Akshun}}


{{CMG}}{{AE}}{{PSD}}
{{Gastrointestinal stromal tumor}}
==Overview==
==Overview==
Abdominal CT scan may be helpful in the diagnosis of gastrointestinal stromal tumor.
A [[Computed tomography|CT scan]] of the [[abdomen]] and [[pelvis]] is the imaging test of choice and an important tool in the [[diagnosis]] of gastrointestinal stromal tumor (GIST). [[CT scan]] can be used to determine the size, location and [[Cancer staging|staging]] of GIST. A [[CT scan]] can accurately de-mark surrounding structures, multiple [[tumors]] and [[metastases]]. On a [[CT scan]], a small GIST (< 5 cms) appears as [[homogeneous]] mass with clear boundaries, while a large GIST (>10cms) appears as a [[heterogeneous]] mass with irregular borders and have local or distant spread.


==CT scan==
==CT scan==
Appearance of GIST on a CT scan vary with size and location. Typically the mass is of soft tissue density with central areas of lower density when necrosis is present (usually in larger tumours). Enhancement is typically peripheral (due to central necrosis). Calcification is uncommon (3%). Metastases (distant, peritoneal, omental) or direct invasion into adjacent organs may be seen in more aggressive lesions. Lymph node enlargement is not a feature.<ref>{{Cite web | title = Gastrointestinal stromal tumour
A [[CT scan]] of the [[abdomen]] and [[pelvis]] is the imaging test of choice and an important tool in the [[diagnosis]] of gastrointestinal stromal tumor (GIST). However, a [[biopsy]] ([[Endoscopy|endoscopic]] or [[CT-scans|CT]] guided) is the [[Gold standard (test)|gold standard]] in diagnosing GIST. <ref>{{Cite web | title = Gastrointestinal stromal tumour
| url = http://radiopaedia.org/articles/gastrointestinal-stromal-tumour-1}}</ref><ref name="pmid15654796">{{cite journal |vauthors=Tran T, Davila JA, El-Serag HB |title=The epidemiology of malignant gastrointestinal stromal tumors: an analysis of 1,458 cases from 1992 to 2000 |journal=Am. J. Gastroenterol. |volume=100 |issue=1 |pages=162–8 |year=2005 |pmid=15654796 |doi=10.1111/j.1572-0241.2005.40709.x |url=}}</ref>
| url = http://radiopaedia.org/articles/gastrointestinal-stromal-tumour-1}}</ref><ref name="pmid15654796">{{cite journal |vauthors=Tran T, Davila JA, El-Serag HB |title=The epidemiology of malignant gastrointestinal stromal tumors: an analysis of 1,458 cases from 1992 to 2000 |journal=Am. J. Gastroenterol. |volume=100 |issue=1 |pages=162–8 |year=2005 |pmid=15654796 |doi=10.1111/j.1572-0241.2005.40709.x |url=}}</ref><ref name="pmid16625094">{{cite journal |vauthors=Miettinen M, Makhlouf H, Sobin LH, Lasota J |title=Gastrointestinal stromal tumors of the jejunum and ileum: a clinicopathologic, immunohistochemical, and molecular genetic study of 906 cases before imatinib with long-term follow-up |journal=Am. J. Surg. Pathol. |volume=30 |issue=4 |pages=477–89 |year=2006 |pmid=16625094 |doi= |url=}}</ref><ref name="pmid12563150">{{cite journal |vauthors=Burkill GJ, Badran M, Al-Muderis O, Meirion Thomas J, Judson IR, Fisher C, Moskovic EC |title=Malignant gastrointestinal stromal tumor: distribution, imaging features, and pattern of metastatic spread |journal=Radiology |volume=226 |issue=2 |pages=527–32 |year=2003 |pmid=12563150 |doi=10.1148/radiol.2262011880 |url=}}</ref><ref name="pmid15855894">{{cite journal |vauthors=Hersh MR, Choi J, Garrett C, Clark R |title=Imaging gastrointestinal stromal tumors |journal=Cancer Control |volume=12 |issue=2 |pages=111–5 |year=2005 |pmid=15855894 |doi= |url=}}</ref><ref name="pmid11034250">{{cite journal |vauthors=Pidhorecky I, Cheney RT, Kraybill WG, Gibbs JF |title=Gastrointestinal stromal tumors: current diagnosis, biologic behavior, and management |journal=Ann. Surg. Oncol. |volume=7 |issue=9 |pages=705–12 |year=2000 |pmid=11034250 |doi= |url=}}</ref>
 
*[[CT scan]] can be used to determine the size, location and [[Cancer staging|staging]] of GIST.  
 
*A [[CT scan]] accurately de-mark surrounding structures, multiple [[tumors]] and [[metastases]].  
*A CT scan of the abdomen and pelvis is the imaging test of choice and an important tool in the diagnosis of GIST.  
*The size of GIST determined by a [[CT scan]] can also be used to classify the severity of GIST.
*CT scan can be used to determine the size, location and staging of the GIST.  
**Small GIST (< 5 cms) are [[homogeneous]] with clear boundaries and have an [[intraluminal]] pattern of growth.
*A CT can accurately de-mark surrounding structures, multiple tumors and metastases.  
**Intermediate GIST (size of 5-10 cms) are [[heterogeneous]] with irregular borders and [[Intraluminal|intra]] or extra-luminal pattern of [[growth]].
*The size of GIST determined by a CT scan can also be ised to classify the severity of GIST.  
**Large GISTs (>10 cms) are [[heterogeneous]] with irregular borders and have local or distant spread.
**Small GIST (< 5 cm) are homogeneous with clear boundaries and intraluminal pattern of growth.
**[[Malignant]] GIST with [[metastasis]] (distant, [[peritoneal]], [[omental]]) may have the following findings:
**Intermediate GIST (size of 5-10 cm) are heterogeneous with irregular borders and intra or extra-luminal pattern of growth.
**Large GISTs (>10 cm) are heterogeneous with irregular borders and local or distant spread.
**Malignant GIST with metastasis may have the following findings:
***Size greater than 10 cm
***Size greater than 10 cm
***Calcifications
***[[Calcification|Calcifications]]
***Irregular margins
***Irregular margins
***Heterogeneous, lobulated
***[[Heterogeneous]] and lobulated
***Lymphadenopathy
***[[Lymphadenopathy]]
***Ulceration
***[[Ulceration]]
***Extraluminal and mesenteric fat infiltration  
***Extraluminal and [[mesenteric]] fat [[Infiltration (medical)|infiltration]]
 
*[[CT-scans|CT]] with [[contrast]] (oral) is superior to a normal [[CT scan]]. A CT with [[contrast]] can better visualize:
 
**Thickness of the [[small bowel]]
CT with contrast (oral) is superior to normal CT. CT with contrast can better visualize the
**Deep ileal loops without [[superimposition]]
*thickness of the small bowel
**Evaluation of surrounding [[mesentery]]
*deep ileal loops without superimposition  
{|
*evaluation of surrounding mesentery
|-
MRI is more accurate than CT for delineating rectal GISTs and in detecting liver metastasis, hemorrhage and necrosis.
|
[[image:GIST CT-Noncontrast image.jpg|thumb|left|CT without contrast showing an incidental finding of a small GIST in the posterior stomach wall (arrow). ([Courtesy: By Inversitus - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=33932071])]]
|
[[image:CT image of a GIST tumor in the gastric cardia.jpg|thumb|center|CT scan showing a GIST located in the gastric cardia. ([Courtesy: By Jto410 (from my radiology practice) [GFDL (http://www.gnu.org/copyleft/fdl.html) or CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons])]]
|
|-
|}


==References==
==References==

Latest revision as of 03:49, 4 March 2019

Gastrointestinal stromal tumor Microchapters

Home

Patient Information

Overview

Historical Perspective

Pathophysiology

Causes

Epidemiology and Demographics

Risk Factors

Screening

Differentiating Gastrointestinal stromal tumor from other Diseases

Natural History, Complications and Prognosis

Diagnosis

Staging

History and Symptoms

Physical Examination

Laboratory Findings

Chest X Ray

CT

MRI

Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Gastrointestinal stromal tumor CT On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Gastrointestinal stromal tumor CT

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Gastrointestinal stromal tumor CT

CDC on Gastrointestinal stromal tumor CT

Gastrointestinal stromal tumor CT in the news

Blogs on Gastrointestinal stromal tumor CT

Directions to Hospitals Treating Gastrointestinal stromal tumor

Risk calculators and risk factors for Gastrointestinal stromal tumor CT

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Akshun Kalia M.B.B.S.[2]

Overview

A CT scan of the abdomen and pelvis is the imaging test of choice and an important tool in the diagnosis of gastrointestinal stromal tumor (GIST). CT scan can be used to determine the size, location and staging of GIST. A CT scan can accurately de-mark surrounding structures, multiple tumors and metastases. On a CT scan, a small GIST (< 5 cms) appears as homogeneous mass with clear boundaries, while a large GIST (>10cms) appears as a heterogeneous mass with irregular borders and have local or distant spread.

CT scan

A CT scan of the abdomen and pelvis is the imaging test of choice and an important tool in the diagnosis of gastrointestinal stromal tumor (GIST). However, a biopsy (endoscopic or CT guided) is the gold standard in diagnosing GIST. [1][2][3][4][5][6]

CT without contrast showing an incidental finding of a small GIST in the posterior stomach wall (arrow). ([Courtesy: By Inversitus - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=33932071])
CT scan showing a GIST located in the gastric cardia. ([Courtesy: By Jto410 (from my radiology practice) [GFDL (http://www.gnu.org/copyleft/fdl.html) or CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons])

References

  1. ↑ "Gastrointestinal stromal tumour".
  2. ↑ Tran T, Davila JA, El-Serag HB (2005). "The epidemiology of malignant gastrointestinal stromal tumors: an analysis of 1,458 cases from 1992 to 2000". Am. J. Gastroenterol. 100 (1): 162–8. doi:10.1111/j.1572-0241.2005.40709.x. PMID 15654796.
  3. ↑ Miettinen M, Makhlouf H, Sobin LH, Lasota J (2006). "Gastrointestinal stromal tumors of the jejunum and ileum: a clinicopathologic, immunohistochemical, and molecular genetic study of 906 cases before imatinib with long-term follow-up". Am. J. Surg. Pathol. 30 (4): 477–89. PMID 16625094.
  4. ↑ Burkill GJ, Badran M, Al-Muderis O, Meirion Thomas J, Judson IR, Fisher C, Moskovic EC (2003). "Malignant gastrointestinal stromal tumor: distribution, imaging features, and pattern of metastatic spread". Radiology. 226 (2): 527–32. doi:10.1148/radiol.2262011880. PMID 12563150.
  5. ↑ Hersh MR, Choi J, Garrett C, Clark R (2005). "Imaging gastrointestinal stromal tumors". Cancer Control. 12 (2): 111–5. PMID 15855894.
  6. ↑ Pidhorecky I, Cheney RT, Kraybill WG, Gibbs JF (2000). "Gastrointestinal stromal tumors: current diagnosis, biologic behavior, and management". Ann. Surg. Oncol. 7 (9): 705–12. PMID 11034250.


Template:WikiDoc Sources

Retrieved from "https://www.wikidoc.org/index.php?title=Gastrointestinal_stromal_tumor_CT&oldid=1555725"