Gastrointestinal stromal tumor of the stomach: Preliminary results of preoperative evaluation with CT gastrography

Background: To determine whether CT gastrography can be used as a comprehensive imaging modality for the evaluation of gastrointestinal stromal tumor (GIST) of the stomach. Methods: Thirty patients with gastric GISTs were included. Using CT gastrography, two radiologists determined the morphology, location, size of the tumor, and the nearest distance from the tumor to the gastroesophageal junction or pylorus in consensus. The ability of 3D CT gastrography in dealing with surface-shaded/transparent images and virtual endoscopic images was also evaluated and compared with the results of barium study and gastroscopy, respectively. Results: In regard to lesion morphology and location, almost perfect agreements (κ = 0.87 ∼ 1.00) were achieved between CT gastrography and surgery, and the difference in lesion size between CT and surgery was not statistically significant (P = 0.824). In terms of the distance from the tumor to the gastroesophageal junction or pylorus, a statistically significant difference was found between the laparoscopic and open gastric surgery groups (P < 0.001). Findings on CT gastrography were mostly similar or superior to those seen on barium study and gastroscopy. Conclusions: CT gastrography can serve as a comprehensive imaging test for the preoperative evaluation of gastric GIST.