Multislice computed tomography imaging of gastrointestinal stromal tumors

Gastrointestinal stromal tumors (GIST) are mesenchymal tumors that constitute 1-3% of primary gastrointestinal tumors and approximately 5% of all sarcomas of the gastrointestinal tract. Multislice Computed Tomography (MSCT) is a highly sensitive imaging technique for detecting GISTs. We retrospectively evaluated findings of 56 consecutive subjects that were examined at Dicle University, School of Medicine, between 2008-2015 and diagnosed with GIST. Lesions were divided into two clinically distinct entities as recurrent and primary lesions. Densities of lesions in comparison to liver, origins of and spreading of the lesions, dimensions of the lesions, behavior pattern, and factors such as contour properties, invasion, and calcification which could potentially indicate malign behavior were also evaluated. Age span of included subjects were between 28 and 81. The most common tumor location for hollow organs was found to be stomach (n=19, 32%). In extra-luminal, regions the most common tumor location was found to be mesentery (n=4). Hansfield Unit densities of tumoral lesions in comparison to liver density were hypodens (n=32, 71%), isodens (n=9, 20%) and hyperdens (n=4, %9) in a descending order. The tumor invasion was found to be effecting liver, peritoneum, and bladder, in a descending order. In 11(24%) subjects, distant metastasis to the liver was evident. In 4(9%) subjects peritoneum, in 3(7%) subjects adrenal gland and in 1(2%) subject bone metastasis was evident. MSCT is an important and indispensable modality for the detection, localization and identification of GISTs that can be seen in different parts of the gastrointestinal tract.


1. Duffaud F, Blay JY. Gastrointestinal stromal tumors: biology and treatment. Oncology 2003; 65: 187-197.

2. Cichoz-Lach H, Kasztelan-Szczerbinska B, Slomka M. Gastrointestinal stromal tumors: epidemiology, clinical picture, diagnosis, prognosis and treatment. Pol Arch Med Wewn, 2008; 118: 216-221.

3. Connolly EM, Gaffney E, Reynolds JV. Gastrointestinal stromal tumours. Br J Surg 2003; 90: 1178-1186.

4. Pidhorecky I, Cheney RT, Kraybill WG, Gibbs JF. Gastrointestinal stromal tumors: current diagnosis, biologic behavior, and management. Ann Surg Oncol 2000; 7: 705-712.

5. Jiang ZX, Zhang SJ, Peng WJ, Yu BH. Rectal gastrointestinal stromal tumors: imaging features with clinical and pathological correlation. World J Gastroenterol 2013; 19: 3108-3116.

6. Miettinen M, Lasota J. Gastrointestinal stromal tumors--definition, clinical, histological, immunohistochemical, and molecular genetic features and differential diagnosis. Virchows Arch 2001; 438: 1-12.

7. Lehnert T. Gastrointestinal sarcoma (GİST)--a review of surgical management. Ann Chir Gynaecol 1998; 87: 297-305.

8. Levine MS, Buck JL, Pantongrag-Brown L, et al. Leiomyosarcoma of the esophagus: radiographic findings in 10 patients. AJR Am J Roentgenol 1996; 167: 27-32.

9. Shojaku H, Futatsuya R, Seto H, et al. Malignant gastrointestinal stromal tumor of the small intestine: radiologic-pathologic correlation. Radiat Med 1997; 15: 189-192.

10. Buckley JA, Fishman EK. CT evaluation of small bowel neoplasms: spectrum of disease. Radiographics 1998; 18: 379-392.

11. Lin YM, Chiu NC, Li AF, et al. Unusual gastric tumors and tumor-like lesions: Radiological with pathological correlation and literature review. World J Gastroenterol 2017; 23: 2493-2504.

12. Bagnolo F, Bonasi U, Scelsi R, Testoni PA. Gastric stromal tumour: a rare neoplasm presenting with gastrointestinal bleeding. Eur J Gastroenterol Hepatol 1998; 10: 791-794.

13. Ghanem N, Altehoefer C, Furtwängler A, et al. Computed tomography in gastrointestinal stromal tumors. Eur Radiol 2003; 13: 1669-78.

14. Sigmund G, Buitrago-Téllez CH, Torhorst J, Steinbrich W. Radiology of gastrointestinal stromal tumor (GİST) and one new case of Carney's syndrome. Fortschr Röntgenstr 2000; 172: 287-294.

15. He MY, Zhang R, Peng Z, et al. Differentiation between gastrointestinal schwannomas and gastrointestinal stromal tumors by computed tomography. Oncol Lett 2017; 13: 3746-3752.

16. Pannu HK, Hruban RH, Fishman EK. CT of gastric leiomyosarcoma: patterns of involvement. AJR 1999; 173: 369-373.

17. Megibow AJ, Balthazar EJ, Hulnick DH, Naidich DP, Bosniak MA. CT evaluation of gastrointestinal leiomyomas and leiomyosarcomas. AJR 1985; 144: 727-731.

18. Laurent F, Raynaud M, Biset JM, et al. Diagnostic and categorization of small bowel neoplasms: role of computer tomography. Gastrointest Radiol 1991; 16: 115-119.

Kaynak Göster