Gastrointestinal stromal tumor CT
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Gastrointestinal stromal tumor Microchapters |
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Differentiating Gastrointestinal stromal tumor from other Diseases |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Akshun Kalia M.B.B.S.[2]
Overview
Abdominal CT scan may be helpful in the diagnosis of gastrointestinal stromal tumor.
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. [1][2][3]
- CT scan can be used to determine the size, location and staging of the GIST.
- A CT can 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 cm) are homogeneous with clear boundaries and intraluminal pattern of growth.
- 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 (distant, peritoneal, omental) may have the following findings:
- Size greater than 10 cm
- Calcifications
- Irregular margins
- Heterogeneous, 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.