Published in:
01-09-2016 | Gastrointestinal
Predictive features of CT for risk stratifications in patients with primary gastrointestinal stromal tumour
Published in: European Radiology | Issue 9/2016
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Purpose
To determine the predictive CT imaging features for risk stratifications in patients with primary gastrointestinal stromal tumours (GISTs).
Materials and methods
One hundred and twenty-nine patients with histologically confirmed primary GISTs (diameter >2 cm) were enrolled. CT imaging features were reviewed. Tumour risk stratifications were determined according to the 2008 NIH criteria where GISTs were classified into four categories according to the tumour size, location, mitosis count, and tumour rupture. The association between risk stratifications and CT features was analyzed using univariate analysis, followed by multinomial logistic regression and receiver operating characteristic (ROC) curve analysis.
Results
CT imaging features including tumour margin, size, shape, tumour growth pattern, direct organ invasion, necrosis, enlarged vessels feeding or draining the mass (EVFDM), lymphadenopathy, and contrast enhancement pattern were associated with the risk stratifications, as determined by univariate analysis (P < 0.05). Only lesion size, growth pattern and EVFDM remained independent risk factors in multinomial logistic regression analysis (OR = 3.480–100.384). ROC curve analysis showed that the area under curve of the obtained multinomial logistic regression model was 0.806 (95 % CI: 0.727–0.885).
Conclusion
CT features including lesion size, tumour growth pattern, and EVFDM were predictors of the risk stratifications for GIST.
Key Points
• CT features were of predictive value for risk stratification of GISTs.
• Tumour size, growth patterns, and EVFDM were risk predictors of GISTs.
• Large size, mixed growth pattern, or EVFDM indicated high risk GIST.