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Abdominal Radiology

, Volume 42, Issue 5, pp 1365–1373 | Cite as

Impact of CT enterography on the diagnosis of small bowel gastrointestinal stromal tumors

  • Rogerio N. Vasconcelos
  • Steven G. Dolan
  • John M. Barlow
  • Michael L. Wells
  • Shannon P. Sheedy
  • Jeff L. Fidler
  • Stephanie Hansel
  • Scott Harmsen
  • Joel G. Fletcher
Article

Abstract

Objective

Our purpose is to determine the impact of CT enterography on small bowel gastrointestinal stromal tumor (GIST) detection and biologic aggressiveness, and to identify any imaging findings that correlate with biologic aggressiveness.

Methods

Records of patients with histologically confirmed small bowel GISTs who underwent CT imaging were reviewed. Biologic aggressiveness was based on initial histologic grading (very low, low, intermediate, high grade; or malignant), with upgrade to malignant category if local or distant metastases developed during clinical follow-up. Imaging indications, findings, and type of CT exam were compared with the biologic aggressiveness.

Results

111 small bowel GISTs were identified, with suspected small bowel bleeding being the most common indication (45/111; 40.5%). While the number of malignant GISTs diagnosed by CT remained relatively constant (2–3 per year), the number of non-malignant GISTs increased substantially (mean 1.5/year, 1998–2005; 8.4/year, 2006–2013). In patients with suspected small bowel bleeding, CT enterography identified 33 GISTs (7/33, 21% malignant) compared to 12 GISTs by abdominopelvic CT (6/12, 50% malignant; p < 0.03). Tumor size (p < 0.0001), internal necrosis (p = 0.005), internal air or enteric contrast (p ≤ 0.021), and ulceration (p ≤ 0.021) were significantly associated with high-grade and malignant tumors, and irregular or invasive tumor borders (p < 0.01) was associated with malignant tumors.

Conclusion

The detection of small bowel GISTs can increase due to the use of CT enterography in patients with suspected small bowel bleeding. The large majority of small bowel GISTs detected by CT enterography are not malignant.

Keywords

CT CT enterography Small bowel GIST 

Notes

Compliance with ethical standards

Funding

No funding was received for this study.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

Informed consent

All patients consented to the retrospective use of medical records for research purposes. This study was approved by our institutional research board.

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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Rogerio N. Vasconcelos
    • 1
  • Steven G. Dolan
    • 2
  • John M. Barlow
    • 1
  • Michael L. Wells
    • 1
  • Shannon P. Sheedy
    • 1
  • Jeff L. Fidler
    • 1
  • Stephanie Hansel
    • 3
  • Scott Harmsen
    • 4
  • Joel G. Fletcher
    • 1
  1. 1.Department of RadiologyMayo ClinicRochesterUSA
  2. 2.Department of RadiologyCork University HospitalCorkIreland
  3. 3.Division of Gastroenterology, Department of Internal MedicineMayo ClinicRochesterUSA
  4. 4.Division of BiostatisticsMayo ClinicRochesterUSA

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