Abstract
BackgroundTo explore whether volumetric CT texture analysis (CTTA) can serve as a potential imaging biomarker for risk stratification of small bowel gastrointestinal stromal tumors (small bowel-GISTs).MethodsA total of 90 patients with small bowel-GISTs were retrospectively reviewed, of these, 26 were rated as high risk, 13 as intermediate risk, and 51 as low or very low risk. Histogram parameters extracted from CT images were compared among small bowel-GISTs with different risk levels by using one-way analysis of variance. Receiver operating characteristics (ROCs) and areas under the curve (AUCs) were analyzed to determine optimal histogram parameters for stratifying tumor risk.ResultsSignificant differences in mean attenuation, 10th, 25th, 50th, 75th and 90th percentile attenuation, and entropy were found among high, intermediate, and low risk small bowel-GISTs (p ≤ 0.001). Mean attenuation, 10th, 25th, 50th, 75th and 90th percentile attenuation, and entropy derived from arterial phase and venous phase images correlated significantly with risk levels (r = 0.403–0.594, r = 0.386–0.593, respectively). Entropy in venous phase reached the highest accuracy (AUC = 0.830, p < 0.001) for differentiating low risk from intermediate to high risk small bowel-GISTs, with a cut-off value of 5.98, and the corresponding sensitivity and specificity were 82.4 and 74.4%, respectively.ConclusionsVolumetric CT texture features, especially entropy, may potentially serve as biomarkers for risk stratification of small bowel-GISTs.
Highlights
To explore whether volumetric computed tomography (CT) texture analysis (CTTA) can serve as a potential imaging biomarker for risk stratification of small bowel gastrointestinal stromal tumors
Small bowel gastrointestinal stromal tumors are common mesenchymal tumors that account for almost 30% of all gastrointestinal stromal tumors (GISTs) [1]
Inclusion criteria were as follows: (1) previous surgery and histopathology confirmed primary small bowel-GISTs; (2) there was no treatment prior to the CT examination; (3) CT resulted in adequate image acquisition and good image quality
Summary
To explore whether volumetric CT texture analysis (CTTA) can serve as a potential imaging biomarker for risk stratification of small bowel gastrointestinal stromal tumors (small bowel-GISTs). Small bowel gastrointestinal stromal tumors (small bowel-GISTs) are common mesenchymal tumors that account for almost 30% of all gastrointestinal stromal tumors (GISTs) [1]. Surgical resection is regarded as the main modality of treatment for localized GISTs. there is a potential risk of postoperative recurrence and metastasis for high risk GISTs within the first five years [2, 3]. The prognosis of small bowel-GISTs has been improved with the introduction of molecularly. Unlike gastric GISTs, small bowel-GISTs are difficult to diagnose and characterize via endoscopic biopsy. Biopsy can increase the risk of tumor seeding [7]. Cross-sectional imaging, especially computed tomography (CT), is currently the main imaging modality used to
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