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- Title
Multiparametric MRI and <sup>18</sup>F-FDG PET features for differentiating gastrointestinal stromal tumors from benign gastric subepithelial lesions.
- Authors
Yoo, Jeongin; Kim, Se Hyung; Han, Joon Koo
- Abstract
<bold>Objectives: </bold>To investigate whether multiparametric magnetic resonance imaging (MRI) and 18F-fluorodeoxyglucose positron emission tomography (PET) can be helpful in differentiating gastrointestinal stromal tumors (GISTs) from non-GISTs and high-risk GISTs from low-risk GISTs.<bold>Methods: </bold>This retrospective study included 56 patients with pathologically confirmed GISTs (n = 39), leiomyoma (n = 8), schwannoma (n = 5), heterotopic pancreas (n = 3), and glomus tumor (n = 1) who underwent MRI and/or PET examinations. Two radiologists reviewed MRI regarding location, shape, contour, growth pattern, margin, signal intensity (SI) on T1- (T1WI) and T2-weighted images (T2WI), degree and pattern of enhancement, hemorrhage, and necrosis. Mean apparent diffusion coefficient (ADC) and maximum standardized uptake value (SUVmax) were measured. Imaging features were compared among non-GISTs, low-risk GISTs, and high-risk GISTs using uni- and multivariate statistical analyses.<bold>Results: </bold>Size, longitudinal location, shape, contour, growth pattern, SI on T1- and T2WI, enhancement pattern, hemorrhage, necrosis, ADC, and SUVmax were significantly different among non-GISTs, low-risk GISTs, and high-risk GISTs (p < 0.05). On multivariate analysis, SI on T2WI (hazard ratio [HR], 66.0; p = 0.002) was the only independent variable for differentiating GISTs from non-GISTs whereas enhancement pattern (HR, 56.0; p = 0.041), ADC (HR, 0.997; p = 0.01), and SUVmax (HR, 2.08; p = 0.027) were significant features for differentiating between high-risk and low-risk GISTs.<bold>Conclusions: </bold>Several qualitative and quantitative MRI and PET features including ADC and SUVmax values are significantly different among non-GISTs, low-risk GISTs, and high-risk GISTs. Multiparametric information obtained from MRI with or without PET can be useful for differentiation of gastric subepithelial tumors as well as for determining patients' management and prognosis.<bold>Key Points: </bold>• Several qualitative MRI features are helpful in distinguishing gastrointestinal stromal tumors (GISTs) from non-GISTs as well as high-risk GISTs from low-risk GISTs. • Apparent diffusion coefficient value on diffusion-weighted imaging can be useful in distinguishing GISTs from non-GISTs as well as high-risk GISTs from low-risk GISTs. • PET has the potential to distinguish between high-risk and low-risk GISTs.
- Subjects
STOMACH tumors; RETROSPECTIVE studies; GASTROINTESTINAL tumors; RADIOPHARMACEUTICALS; DEOXY sugars; PHARMACODYNAMICS
- Publication
European Radiology, 2020, Vol 30, Issue 3, p1634
- ISSN
0938-7994
- Publication type
Journal Article
- DOI
10.1007/s00330-019-06534-9