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Contribution of CT to treatment planning in patients with GIST

Apporto della tomografia computerizzata nella pianificazione terapeutica del paziente con GIST

  • Abdominal Radiology Radiologia Addominale
  • Published:
La radiologia medica Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study was to illustrate the morphological and structural computed tomography (CT) patterns of gastrointestinal stromal tumours (GIST) and to discuss the technique’s role in identifying lesions at a higher risk for malignant potential, in treatment planning and in the follow-up of patients with GIST.

Materials and methods

We retrospectively reviewed the CT scans of 26 patients who underwent surgery for histologically confirmed GIST of the stomach (20 cases), the duodenum (1), the caecum (1), the small bowel (2), the descending colon (1) and the rectum (1). CT exams were performed with a single-slice scanner and a 5-mm collimation before and after the intravenous administration of contrast material.

Results

CT allowed us to correctly define the site, size and structure of lesions in all cases and to identify signs of invasion of neighbouring structures in some cases. The lesions exhibited solid density on the unenhanced scan and poor enhancement after contrast-medium administration; lesion structure was homogeneous in ten cases and inhomogeneous in 16; in one case, histology revealed microcalcification that had not been detected by CT.

Conclusions

CT, with its panoramic capabilities and high contrast resolution, provides essential information for treatment planning and for the follow-up of GIST patients treated with surgery or chemotherapy.

Riassunto

Obiettivo

Lo scopo di questo lavoro è stato quello di riportare quelle che sono le caratteristiche dei tumori gastro-intestinali stromali (GIST) evidenziabili in TC ed utili nell’identificazione delle lesioni a maggior rischio di malignità e nella pianificazione della terapia e nel follow-up.

Materiali e metodi

Sono stati valutati retrospettivamente gli esami TC di 26 pazienti sottoposti ad intervento chirurgico con diagnosi istologica di GIST localizzato allo stomaco (20 casi), al duodeno (1), al cieco (1), all’intestino tenue (2), al colon discendente (1) ed al retto (1). Gli esami TC sono stati eseguiti utilizzando un’apparecchiatura TC spirale a singolo strato con collimazione di 5 mm, mediante scansioni dirette e dopo MdC per via endovenosa.

Risultati

La TC ha consentito sempre di individuare correttamente sede, dimensioni e struttura delle lesioni ed in alcuni casi anche segni di infiltrazione dei tessuti circostanti. Le lesioni presentavano densità solida alle scansioni dirette, uno scarso enhancement dopo MdC, struttura omogenea in 10 casi, disomogenea in 16; in un caso si sono evidenziate alcune microcalcificazioni all’esame istologico, non riscontrate all’esame TC.

Conclusioni

La TC in virtù della sua elevata panoramicità e risoluzione di contrasto fornisce informazioni indispensabili nella pianificazione terapeutica e nel follow-up dei pazienti trattati sia chirurgicamente sia mediante terapia farmacologica.

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Authors and Affiliations

  1. Unità Clinico Operativa di Radiologia, Università degli Studi di Trieste, Ospedale di Cattinara, Strada di Fiume 447, I-34149, Trieste, Italy

    A. Rimondini, M. Belgrano, G. Favretto & M. A. Cova

  2. Unità Clinico Operativa di Clinica Generale e Terapia Chirurgica, Università degli Studi di Trieste, Ospedale di Cattinara, Strada di Fiume 447, I-34149, Trieste, Italy

    A. Spivach & A. Sartori

  3. Unità Clinico Operativa di Anatomia Patologica Istopatologia e Citodiagnostica, Università degli Studi di Trieste, Ospedale Maggiore, Via della Pietà 2, I-34100, Trieste, Italy

    F. Zanconati

Authors
  1. A. Rimondini
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  2. M. Belgrano
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  3. G. Favretto
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  4. A. Spivach
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  5. A. Sartori
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  6. F. Zanconati
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  7. M. A. Cova
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Correspondence to A. Rimondini.

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Rimondini, A., Belgrano, M., Favretto, G. et al. Contribution of CT to treatment planning in patients with GIST. Radiol med 112, 691–702 (2007). https://doi.org/10.1007/s11547-007-0173-1

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  • DOI: https://doi.org/10.1007/s11547-007-0173-1

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