Gastrointestinal stromal tumor CT: Difference between revisions
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==Overview== | ==Overview== | ||
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]] 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== | ||
A CT scan of the abdomen and pelvis is the imaging test of choice and an important tool in the diagnosis of GIST. However, a biopsy (endoscopic or CT guided) is the gold standard in diagnosing GIST. <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]] (endoscopic or 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><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> | | 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> | ||
*CT scan can be used to determine the size, location and staging of | *[[CT scan]] can be used to determine the size, location and [[Cancer staging|staging]] of GIST. | ||
*A CT | *A [[CT scan]] accurately de-mark surrounding structures, multiple [[tumors]] and [[metastases]]. | ||
*The size of GIST determined by a CT scan can also be used to classify the severity of GIST. | *The size of GIST determined by a [[CT scan]] can also be used to classify the severity of GIST. | ||
**Small GIST (< 5 | **Small GIST (< 5 cms) are [[homogeneous]] with clear boundaries and have an [[intraluminal]] pattern of growth. | ||
**Intermediate GIST (size of 5-10 | **Intermediate GIST (size of 5-10 cms) are [[heterogeneous]] with irregular borders and [[Intraluminal|intra]] or extra-luminal pattern of [[growth]]. | ||
**Large GISTs (>10 | **Large GISTs (>10 cms) are [[heterogeneous]] with irregular borders and have local or distant spread. | ||
**Malignant GIST with metastasis (distant, peritoneal, omental) may have the following findings: | **Malignant GIST with metastasis (distant, [[peritoneal]], [[omental]]) may have the following findings: | ||
***Size greater than 10 cm | ***Size greater than 10 cm | ||
***Calcifications | ***[[Calcification|Calcifications]] | ||
***Irregular margins | ***Irregular margins | ||
***Heterogeneous | ***[[Heterogeneous]] and lobulated | ||
***Lymphadenopathy | ***[[Lymphadenopathy]] | ||
***Ulceration | ***[[Ulceration]] | ||
***Extraluminal and mesenteric fat infiltration | ***Extraluminal and [[mesenteric]] fat infiltration | ||
*CT with contrast (oral) is superior to a normal CT scan. A CT with contrast can better visualize: | *CT with contrast (oral) is superior to a normal CT scan. A CT with contrast can better visualize: | ||
**Thickness of the small bowel | **Thickness of the [[small bowel]] | ||
**Deep ileal loops without superimposition | **Deep ileal loops without [[superimposition]] | ||
**Evaluation of surrounding mesentery | **Evaluation of surrounding [[mesentery]] | ||
*MRI is more accurate than CT for delineating rectal GISTs and in detecting liver metastasis, hemorrhage and necrosis. | *MRI is more accurate than CT for delineating rectal GISTs and in detecting liver [[metastasis]], [[hemorrhage]] and [[necrosis]]. | ||
Revision as of 23:55, 17 December 2017
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Gastrointestinal stromal tumor Microchapters |
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Differentiating Gastrointestinal stromal tumor from other Diseases |
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Gastrointestinal stromal tumor CT On the Web |
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American Roentgen Ray Society Images of Gastrointestinal stromal tumor CT |
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Directions to Hospitals Treating Gastrointestinal stromal tumor |
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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 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]
- CT scan can be used to determine the size, location and staging of GIST.
- A CT scan accurately de-mark surrounding structures, multiple tumors and metastases.
- The size of GIST determined by a CT scan can also be used to classify the severity of GIST.
- Small GIST (< 5 cms) are homogeneous with clear boundaries and have an intraluminal pattern of growth.
- Intermediate GIST (size of 5-10 cms) are heterogeneous with irregular borders and intra or extra-luminal pattern of growth.
- Large GISTs (>10 cms) are heterogeneous with irregular borders and have local or distant spread.
- Malignant GIST with metastasis (distant, peritoneal, omental) may have the following findings:
- Size greater than 10 cm
- Calcifications
- Irregular margins
- Heterogeneous and lobulated
- Lymphadenopathy
- Ulceration
- Extraluminal and mesenteric fat infiltration
- CT with contrast (oral) is superior to a normal CT scan. A CT with contrast can better visualize:
- Thickness of the small bowel
- 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.
References
- ↑ "Gastrointestinal stromal tumour".
- ↑ 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.
- ↑ 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.