ROLE OF CROSS-SECTIONAL IMAGING IN DIAGNOSIS AND MANAGEMENT PLANNING OF GASTROINTESTINAL STROMAL TUMORS
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 4, Pages 135-149
Abstract
Background information -Gastrointestinal stromal tumors (GISTs)arise from the interstitialcell of Cajal are the most common mesenchymal neoplasms of the gastrointestinal tract. The
imaging features of GISTs have only been described in very limited studies. Hence the
present study was designed to evaluate CT/MRI findings of Gastrointestinal stromal tumors
and to identify appropriate biopsy options. Further To identify the criteria on cross sectional
imaging, which determine operability and non-operability of gastrointestinal stromal tumors.
Methods- 36 clinically suspected GIST and subsequent histopathologically proven cases
were selected. Based on imaging findings appropriate biopsy options were considered i.e.,
percutaneous image guided CT/ ultrasound guided/ Endosonological/Laparoscopic or open
biopsies. Lesions which are classified as operable are subjected to surgical excision if other
conditions are favorable for surgery. Intraoperative findings were studied for correlation and
agreement with findings on cross sectional imaging. Inoperable cases were planned for
imatinib therapy and close follow-up.
Results and conclusion - We found that the cross-sectional imaging findings were accurate
in predicting the operability of GISTs. In this study cross sectional imaging (CT/MRI) had
sensitivity of 95.83%, PPV was 100% and Diagnostic Accuracy was 95.83% for GISTs.Cross
sectional imaging findings were very helpful in characterizing the tumor, deciding the
appropriate biopsy option and operability and non-operability in cases of GISTs.Overall,
Cross sectional imaging played a vital role in deciding the best therapeutic options for the
patients.Pre-operative staging is incredibly important to see the operability of tumor. It also
helps to search for lymph nodal involvement and metastasis preoperatively.It also helps in
post-operative follow-up or follow-up in patients on imatinib to look for therapeutic response
and in detection of local recurrence and metastasis.
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