A scoring model for radiologic diagnosis of gastric leiomyomas (GLMs) with contrast-enhanced computed tomography (CE-CT): Differential diagnosis from gastrointestinal stromal tumors (GISTs)

Xu, Jianxia; Ding, Qiaoling; Lu, Yuan‐Fei; Fan, Shuli; Rao, Qin-Pan; Yu, Ri‐Sheng

doi:10.1016/j.ejrad.2020.109395

Cited by 10 publications

(11 citation statements)

References 21 publications

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“…Endoscopic ultrasonography shows that gastric wall GISTs mostly occur in the fourth layer of the gastric wall, namely, the muscularis propria, so they can grow both inside and outside the cavity [6]. GLMs mostly originate from the third layer, the muscularis mucosae, so they grow toward the mucosal surface with less growth resistance and protrude into the lumen, which is consistent with the results of previous studies [7][8][9], indicating that the histological location and growth pattern of small GISTs are similar to conventional lesions.…”

Section: Discussionsupporting

confidence: 90%

Differentiation of Small Gastrointestinal Stromal Tumor and Gastric Leiomyoma with Contrast‐Enhanced CT

Yan

Liu

You

et al. 2023

Journal of Healthcare Engineering

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Objective. The value of multiphase contrast-enhanced CT in differentiating gastrointestinal stromal tumors (GISTs) and gastric leiomyomas (GLMs) which were ≤3 cm was evaluated using machine learning. Methods. A retrospective analysis was conducted on 45 cases of small gastric wall submucosal tumors (including 22 GISTs and 23 GLMs) with pathologically confirmed diameter ≤3 cm and completed multiphase CT-enhanced scan images. The CT features including tumor location, maximum diameter, shape, margins, growth pattern, plain/enhanced CT value, cystic degeneration, calcification, ulcer, progressive reinforcement, perilesional lymph nodes, and the CT value ratio of the tumor to the aorta at the same level in the enhanced phase III scan of the two groups were evaluated. Tumor location and maximum diameter were automatically evaluated by machine learning. Results. The GISTs and GLMs with a diameter ≤3 cm showed clear margins, uniform density on plain scan CT, and progressive homogeneous enhancement. The age of the GISTs is greater than that of the GLMs group. The plain scan CT value of the GISTs group was lower than that in the GLMs group. In the GISTs group, the lesions were mostly located in the fundus (68.18%), showing a mixed growth pattern (54.55%), and in the GLMs group, most lesions were located in the cardia (47.82%), showing an intraluminal growth pattern (95.65%). The abovementioned differences were statistically significant. Conclusions. Contrast-enhanced CT has limited value in differentiating small GISTs from GLMs, which are ≤3 cm. Older age (>49.0 years), a low plain CT value (<42.5 Hu), mixed growth inside and outside the cavity, and noncardiac location tended to be the criteria for the diagnosis of small GISTs of the gastric wall.

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Section: Discussionsupporting

confidence: 90%

Differentiation of Small Gastrointestinal Stromal Tumor and Gastric Leiomyoma with Contrast‐Enhanced CT

Yan

Liu

You

et al. 2023

Journal of Healthcare Engineering

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“…Therefore, the morphological characteristics of the two tumors are very similar and cannot be used as a basis for the differential diagnosis. Xu et al 16 proposed a very interesting scoring system to distinguish these two tumors, thus providing a valuable solution. Their research showed that the tumor site, necrosis, and LD/VD ratio with a diameter of <5 cm were statistically significant; however, the influence of other confounding factors was not controlled.…”

Section: Discussionmentioning

confidence: 99%

Computed tomography features of gastric leiomyoma versus gastric stromal tumor: a case–control study with propensity score matching

Wang

et al. 2023

J Int Med Res

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Objective To differentiate gastric leiomyomas (GLs) and gastric stromal tumors (GSTs) based on preoperative enhanced computed tomography characteristics. Methods Twenty-six pathologically confirmed GLs were propensity score-matched to 26 GSTs in a 1:1 ratio based on sex, age, tumor site, and tumor size. Tumor shape and contour, mucosal ulceration, growth pattern, enhancement pattern and degree, longest diameter, and longest diameter/vertical diameter ratio were compared between the groups. Hemorrhage, calcification, peripheral invasion, and distant metastasis were also included in the regression analysis for differentiation of the two tumors. Results Mucosal ulceration was significantly more frequent in GSTs than GLs. The enhancement degree of GSTs was significantly higher than that of GLs in the arterial and portal venous phases. Using enhancement degrees of 18 HU and 23 HU in the arterial phase and venous phase as cutoff values, respectively, we found that an enhancement degree of <18 HU in the arterial phase was an independent influential factor for diagnosis of GLs. No significant differences were found in other morphological characteristics. GLs did not metastasize or invade adjacent tissues. Conclusion A low enhancement degree in GLs is the most valuable quantitative feature for differentiating these two similar tumors.

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“…We believe that the enhancement examination can reveal a cluster-like small vascular shadow around the tumor. Previous studies have suggested that enhancement may be related to the malignant degree of the tumor, and a low malignant degree of the tumor may lead to uniform and moderate enhancement, or tumor necrosis and cystic degeneration[ 11 - 14 ]. ROC curve analysis showed that the arterial CT value and enhanced peak CT value had a certain sensitivity and specificity in the differential diagnosis of GST and gastric polyps.…”

Section: Discussionmentioning

confidence: 99%

Multi-slice spiral computed tomography in differential diagnosis of gastric stromal tumors and benign gastric polyps, and gastric stromal tumor risk stratification assessment

Li¹,

Han²,

Wang³

et al. 2022

World J Gastrointest Oncol

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BACKGROUND The biological characteristics of gastric stromal tumors are complex, and their incidence has increased in recent years. Gastric stromal tumors (GST) have potential malignant tendencies, and the probability of transformation into malignant tumors is as high as 20%-30%. AIM To investigate the value of multi-slice spiral computed tomography (MSCT) in the differential diagnosis of GST and benign gastric polyps, and GST risk stratification assessment. METHODS We included 64 patients with GST (GST group) and 60 with benign gastric polyps (control group), confirmed by pathological examination after surgery in PLA General Hospital, from January 2016 to June 2021. The differences in the MSCT imaging characteristic parameters and enhanced CT values between the two groups before surgery were compared. According to the National Institutes of Health’s standard, GST is divided into low- and high-risk groups for MSCT imaging characteristic parameters and enhanced CT values. RESULTS The incidences of extraluminal growth, blurred boundaries, and ulceration in the GST group were significantly higher than those in the control group ( P < 0.05). The CT values and enhanced peak CT values in the arterial phase in the CST group were higher than those in the control group ( P < 0.05). The MSCT differential diagnosis of GST and gastric polyp sensitivity, specificity, misdiagnosis rate, missed diagnosis rate, and areas under the curve (AUCs) were 73.44 %, 83.33%, 26.56%, 16.67%, 0.784, respectively. The receiver operating characteristic curves were plotted with the arterial CT value and enhanced peak CT value, with a statistical difference. The results showed that the sensitivity, specificity, misdiagnosis rate, missed diagnosis rate, and AUC value of arterial CT in the differential diagnosis of GST and gastric polyps were 80.18%, 62.20%, 19.82%, 37.80%, and 0.710, respectively. The sensitivity, specificity, misdiagnosis rate, missed diagnosis rate, and AUC value of the enhanced peak CT value in the differential diagnosis of GST and gastric polyps were 67.63%, 60.40%, 32.37%, 39.60%, and 0.710, respectively. The incidence of blurred lesion boundaries and ulceration in the high-risk group was significantly higher than that in the low-risk group ( P < 0.05). The arterial phase and enhanced peak CT values in the high-risk group were significantly higher than those in the low-risk group ( P < 0.05). CONCLUSION Presurgical MSCT examination has important value in the differential diagnosis of GST and gastric benign polyps and can effectively evaluate the risk grade of GST patients.

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A scoring model for radiologic diagnosis of gastric leiomyomas (GLMs) with contrast-enhanced computed tomography (CE-CT): Differential diagnosis from gastrointestinal stromal tumors (GISTs)

Cited by 10 publications

References 21 publications

Differentiation of Small Gastrointestinal Stromal Tumor and Gastric Leiomyoma with Contrast‐Enhanced CT

Differentiation of Small Gastrointestinal Stromal Tumor and Gastric Leiomyoma with Contrast‐Enhanced CT

Computed tomography features of gastric leiomyoma versus gastric stromal tumor: a case–control study with propensity score matching

Multi-slice spiral computed tomography in differential diagnosis of gastric stromal tumors and benign gastric polyps, and gastric stromal tumor risk stratification assessment

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