Gastrointestinal stromal tumor CT

A CT scan of the abdomen and pelvis is the imaging test of choice and an important tool in the diagnosis of gastrointestinal stromal tumor (GIST). CT scan can be used to determine the size, location and staging of GIST. A CT scan can accurately de-mark surrounding structures, multiple tumors and metastases. On a CT scan, a small GIST (< 5 cms) appears as homogeneous mass with clear boundaries, while a large GIST (>10cms) appears as a heterogeneous mass with irregular borders and have local or distant spread.

A CT scan of the abdomen and pelvis is the imaging test of choice and an important tool in the diagnosis of gastrointestinal stromal tumor (GIST). However, a biopsy (endoscopic or CT guided) is the gold standard in diagnosing GIST. ^{[1][2][3][4][5][6]}

• CT scan can be used to determine the size, location and staging of GIST.
• A CT scan accurately de-mark surrounding structures, multiple tumors and metastases.
• The size of GIST determined by a CT scan can also be used to classify the severity of GIST.
  • Small GIST (< 5 cms) are homogeneous with clear boundaries and have an intraluminal pattern of growth.
  • Intermediate GIST (size of 5-10 cms) are heterogeneous with irregular borders and intra or extra-luminal pattern of growth.
  • Large GISTs (>10 cms) are heterogeneous with irregular borders and have local or distant spread.
  • Malignant GIST with metastasis (distant, peritoneal, omental) may have the following findings:
    • Size greater than 10 cm
    • Calcifications
    • Irregular margins
    • Heterogeneous and lobulated
    • Lymphadenopathy
    • Ulceration
    • Extraluminal and mesenteric fat infiltration
• CT with contrast (oral) is superior to a normal CT scan. A CT with contrast can better visualize:
  • Thickness of the small bowel
  • Deep ileal loops without superimposition
  • Evaluation of surrounding mesentery

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