Gastrointestinal stromal tumor MRI

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Akshun Kalia M.B.B.S.[2]

Overview

MRI is more accurate and sensitive than a CT scan for delineating rectal gastrointestinal stromal tumors (GISTs). For GISTs located at other locations MRI is as sensitive as a CT scan. However, a biopsy (endoscopic or CT guided) is the gold standard in diagnosing GIST. On a T1 weighted MRI, low signal intensity indicates solid component GIST whereas on a T2 weighted MRI, high signal intensity indicates solid component GISTs.

MRI

MRI is more accurate and sensitive than a CT scan for delineating rectal gastrointestinal stromal tumors (GISTs). For GISTs located at other locations MRI is as sensitive as a CT scan.^[1]^[2]

MRI is more sensitive in identifying GIST associated hemorrhage, necrosis, surrounding structures and metastasis.
On an MRI, the presence of hemorrhage, necrosis and cystic change may have variable appearance:
- On a T1 weighted MRI:
  - Low signal intensity indicates solid component GISTs.
  - With larger GISTs, contrast induced enhancement is present and predominantly peripheral in larger lesions (>10 cms).
- On a T2 weighted MRI
  - High signal intensity indicates solid component GISTs.

References

↑ Nilsson B, Bümming P, Meis-Kindblom JM, Odén A, Dortok A, Gustavsson B, Sablinska K, Kindblom LG (2005). “Gastrointestinal stromal tumors: the incidence, prevalence, clinical course, and prognostication in the preimatinib mesylate era–a population-based study in western Sweden”. Cancer. 103 (4): 821–9. doi:10.1002/cncr.20862. PMID 15648083.
↑ Heinrich MC, Corless CL, Demetri GD, Blanke CD, von Mehren M, Joensuu H, McGreevey LS, Chen CJ, Van den Abbeele AD, Druker BJ, Kiese B, Eisenberg B, Roberts PJ, Singer S, Fletcher CD, Silberman S, Dimitrijevic S, Fletcher JA (2003). “Kinase mutations and imatinib response in patients with metastatic gastrointestinal stromal tumor”. J. Clin. Oncol. 21 (23): 4342–9. doi:10.1200/JCO.2003.04.190. PMID 14645423.

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[pmid15648083-1] Nilsson B, Bümming P, Meis-Kindblom JM, Odén A, Dortok A, Gustavsson B, Sablinska K, Kindblom LG (2005). “Gastrointestinal stromal tumors: the incidence, prevalence, clinical course, and prognostication in the preimatinib mesylate era–a population-based study in western Sweden”. Cancer. 103 (4): 821–9. doi:10.1002/cncr.20862. PMID 15648083.

[pmid14645423-2] Heinrich MC, Corless CL, Demetri GD, Blanke CD, von Mehren M, Joensuu H, McGreevey LS, Chen CJ, Van den Abbeele AD, Druker BJ, Kiese B, Eisenberg B, Roberts PJ, Singer S, Fletcher CD, Silberman S, Dimitrijevic S, Fletcher JA (2003). “Kinase mutations and imatinib response in patients with metastatic gastrointestinal stromal tumor”. J. Clin. Oncol. 21 (23): 4342–9. doi:10.1200/JCO.2003.04.190. PMID 14645423.

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