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CT Versus Endoscopic Ultrasound for Differentiating Small (2-5 cm) Gastrointestinal Stromal Tumors From Leiomyomas

Authors
 Cheal Wung Huh  ;  Da Hyun Jung  ;  Joon Sung Kim  ;  Yu Ri Shin  ;  Seung Ho Choi  ;  Byung-Wook Kim 
Citation
 AMERICAN JOURNAL OF ROENTGENOLOGY, Vol.213(3) : 586-591, 2019 
Journal Title
 AMERICAN JOURNAL OF ROENTGENOLOGY 
ISSN
 0361-803X 
Issue Date
2019
MeSH
Contrast Media ; Diagnosis, Differential ; Endosonography/methods* ; Female ; Gastrointestinal Stromal Tumors/diagnostic imaging* ; Gastrointestinal Stromal Tumors/pathology ; Humans ; Male ; Middle Aged ; Sensitivity and Specificity ; Stomach Neoplasms/diagnostic imaging* ; Stomach Neoplasms/pathology ; Tomography, X-Ray Computed/methods*
Keywords
endosonography ; gastric neoplasm ; radiographic CT
Abstract
OBJECTIVE. Abdominal CT or endoscopic ultrasound is recommended for the evaluation of gastric subepithelial tumors. However, few studies have compared the diagnostic performance of these two methods. We compared the diagnostic performance of CT versus endoscopic ultrasound for gastric subepithelial tumors smaller than 5 cm. We also identified significant CT findings associated with the diagnosis of gastrointestinal stromal tumors. MATERIALS AND METHODS. Seventy-one patients with pathologically proven gastric subepithelial tumors were enrolled. We examined the diagnostic performance of CT compared with endoscopic ultrasound. We analyzed CT findings, including the location, long diameter (LD), short diameter (SD), LD-SD ratio, contour, margin, growth pattern, degree and pattern of enhancement, attenuation value, intralesional necrosis, calcification, hemorrhage, surface dimpling, and perilesional lymph node. RESULTS. Endoscopic ultrasound had a sensitivity of 77.6%, specificity of 61.5%, PPV of 90.0%, NPV of 38.1%, and accuracy of 74.6%. CT had a sensitivity of 84.5%, specificity of 53.8%, PPV of 89.1%, NPV of 43.8%, and accuracy of 78.9%. Multivariate analysis revealed that the presence of intralesional necrosis (odds ratio [OR], 10.88; p = 0.037) and an LD-SD ratio less than 1.5 (OR, 32.37; p = 0.002) were independent CT findings for the diagnosis of gastrointestinal stromal tumors. CONCLUSION. CT is as effective as endoscopic ultrasound for the diagnosis of gastric subepithelial tumors smaller than 5 cm. Tumors with intralesional necrosis and an LD-SD ratio less than 1.5 may require further pathologic diagnosis.
Full Text
https://www.ajronline.org/doi/full/10.2214/AJR.18.20877
DOI
10.2214/AJR.18.20877
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Jung, Da Hyun(정다현)
Choi, Seung Ho(최승호) ORCID logo https://orcid.org/0000-0002-9872-3594
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/175213
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