Contrast extravasation on computed tomography angiography in patients with hematochezia or melena: Predictive factors and associated outcomes

Barat, Maxime; Marchese, Ugo; Shotar, Eimad; Chousterman, Benjamin; Barret, Maximilien; Dautry, Raphaël; Kedra, Alice; Fuks, David; Soyer, Philippe; Dohan, Anthony

doi:10.1016/j.diii.2021.09.006

Cited by 7 publications

(5 citation statements)

References 48 publications

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“…Extravasation of iodine contrast material, indicating active arterial bleeding from a corresponding point, and hyperattenuating intraluminal material, suggesting recent hemorrhage, are critical findings of gastrointestinal bleeding on CT [ 87 ]. Extravasation of iodine contrast media is frequently observed in patients with acute massive gastrointestinal bleeding presenting hemodynamical instability [ 88 ]. However, gastrointestinal bleeding caused by GISTs is generally not massive [ 89 ].…”

Section: Complicationsmentioning

confidence: 99%

Gastrointestinal stromal tumors: a comprehensive radiological review

Inoue

Ota²,

Yamasaki

et al. 2022

Jpn J Radiol

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Gastrointestinal stromal tumors (GISTs) originating from the interstitial cells of Cajal in the muscularis propria are the most common mesenchymal tumor of the gastrointestinal tract. Multiple modalities, including computed tomography (CT), magnetic resonance imaging (MRI), fluorodeoxyglucose positron emission tomography, ultrasonography, digital subtraction angiography, and endoscopy, have been performed to evaluate GISTs. CT is most frequently used for diagnosis, staging, surveillance, and response monitoring during molecularly targeted therapy in clinical practice. The diagnosis of GISTs is sometimes challenging because of the diverse imaging findings, such as anatomical location (esophagus, stomach, duodenum, small bowel, colorectum, appendix, and peritoneum), growth pattern, and enhancement pattern as well as the presence of necrosis, calcification, ulceration, early venous return, and metastasis. Imaging findings of GISTs treated with antineoplastic agents are quite different from those of other neoplasms (e.g. adenocarcinomas) because only subtle changes in size are seen even in responsive lesions. Furthermore, the recurrence pattern of GISTs is different from that of other neoplasms. This review discusses the advantages and disadvantages of each imaging modality, describes imaging findings obtained before and after treatment, presents a few cases of complicated GISTs, and discusses recent investigations performed using CT and MRI to predict histological risk grade, gene mutations, and patient outcomes.

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Section: Complicationsmentioning

confidence: 99%

Gastrointestinal stromal tumors: a comprehensive radiological review

Inoue

Ota²,

Yamasaki

et al. 2022

Jpn J Radiol

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“…3 Clinically, GISTs are frequently revealed by acute gastrointestinal bleeding due to mucosal ulceration, anemia caused by chronic bleeding, spontaneous rupture, or intussusception. 4,5…”

Section: Introductionmentioning

confidence: 99%

“…3 Clinically, GISTs are frequently revealed by acute gastrointestinal bleeding due to mucosal ulceration, anemia caused by chronic bleeding, spontaneous rupture, or intussusception. 4,5 Another specific characteristic of GISTs is the presence of gene mutations. 6,7 Eighty to 85% of GISTs harbor activating mutations in the KIT protooncogene and 5-10% harbor mutations in platelet-derived growth factor receptor alpha (PDGFRA) genes, with the 2 mutations being mutually exclusive.…”

Section: Introductionmentioning

confidence: 99%

CT and MRI of Gastrointestinal Stromal Tumours: New Trends and Perspectives

et al. 2023

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Gastrointestinal stromal tumors (GISTs) are defined as mesenchymal tumors of the gastrointestinal tract that express positivity for CD117, which is a c- KIT proto-oncogene antigen. Expression of the c- KIT protein, a tyrosine kinase growth factor receptor, allows the distinction between GISTs and other mesenchymal tumors such as leiomyoma, leiomyosarcoma, schwannoma and neurofibroma. GISTs can develop anywhere in the gastrointestinal tract, as well as in the mesentery and omentum. Over the years, the management of GISTs has improved due to a better knowledge of their behaviors and risk or recurrence, the identification of specific mutations and the use of targeted therapies. This has resulted in a better prognosis for patients with GISTs. In parallel, imaging of GISTs has been revolutionized by tremendous progress in the field of detection, characterization, survival prediction and monitoring during therapy. Recently, a particular attention has been given to radiomics for the characterization of GISTs using analysis of quantitative imaging features. In addition, radiomics has currently many applications that are developed in conjunction with artificial intelligence with the aim of better characterizing GISTs and providing a more precise assessment of tumor burden. This article sums up recent advances in computed tomography and magnetic resonance imaging of GISTs in the field of image/data acquisition, tumor detection, tumor characterization, treatment response evaluation, and preoperative planning.

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“…[3][4][5] Finally, GISTs can be found in a variety of scenarios including chronic anemia secondary to chronic bleeding, acute gastrointestinal bleeding due to mucosal ulceration, spontaneous tumour rupture in case of larger GIST, or gastrointestinal obstruction secondary to intussusception. [5][6][7] Computed tomography (CT) is the most commonly used imaging technique for the assessment of GISTs. 4,5,[7][8][9] CT provides crucial information that can suggest the diagnosis of GIST.…”

Section: Introductionmentioning

confidence: 99%

“…3-5 Finally, GISTs can be found in a variety of scenarios including chronic anemia secondary to chronic bleeding, acute gastrointestinal bleeding due to mucosal ulceration, spontaneous tumour rupture in case of larger GIST, or gastrointestinal obstruction secondary to intussusception. 5-7…”

Section: Introductionmentioning

confidence: 99%

Cinematic Rendering of Gastrointestinal Stromal Tumours: A Review of Current Possibilities and Future Developments

Barat,

Pellat,

Terris

et al. 2023

Can Assoc Radiol J

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Gastrointestinal stromal tumors (GISTs) are defined as CD117-positive primary, spindled or epithelioid, mesenchymal tumors of the gastrointestinal tract, omentum, or mesentery. While computed tomography (CT) is the recommended imaging modality for GISTs, overlap in imaging features between GISTs and other gastrointestinal tumors often make radiological diagnosis and subsequent selection of the optimal therapeutic approach challenging. Cinematic rendering is a novel CT post-processing technique that generates highly photorealistic anatomic images based on a unique lighting model. The global lighting model produces high degrees of surface detail and shadowing effects that generate depth in the final three-dimensional display. Early studies have shown that cinematic rendering produces high-quality images with enhanced detail by comparison with other three-dimensional visualization techniques. Cinematic rendering shows promise in improving the visualization of enhancement patterns and internal architecture of abdominal lesions, local tumor extension, and global disease burden, which may be helpful for lesion characterization and pretreatment planning. This article discusses and illustrates the application of cinematic rendering in the evaluation of GISTs and the unique benefit of using cinematic rendering in the workup of GIST with a specific emphasis on tumor characterization and preoperative planning.

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Contrast extravasation on computed tomography angiography in patients with hematochezia or melena: Predictive factors and associated outcomes

Cited by 7 publications

References 48 publications

Gastrointestinal stromal tumors: a comprehensive radiological review

Gastrointestinal stromal tumors: a comprehensive radiological review

CT and MRI of Gastrointestinal Stromal Tumours: New Trends and Perspectives

Cinematic Rendering of Gastrointestinal Stromal Tumours: A Review of Current Possibilities and Future Developments

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