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Imaging features of primary anorectal gastrointestinal stromal tumors with clinical and pathologic correlation.

Koch MR, Jagannathan JP, Shinagare AB, Krajewski KM, Raut CP, Hornick JL, Ramaiya NH - Cancer Imaging (2013)

Bottom Line: The tumors were FDG avid with a mean maximum standardized uptake value of 11 (8.4-16.8).All tumors were positive for KIT and CD34.Distant metastasis to liver was seen in 1 patient (6.3%) at presentation.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA.

ABSTRACT

Purpose: To evaluate the imaging features of anorectal gastrointestinal stromal tumors (GISTs) with clinical and histopathologic correlation.

Materials and methods: In this Institutional Review Board-approved, Health Insurance Portability and Accountability Act-compliant retrospective study, 16 patients (12 men; mean age 66 years (30-89 years)) with pathologically proven anorectal GISTs seen at our institution from January 2001 to July 2011 were identified. Electronic medical records were reviewed to obtain clinical data. Pretreatment imaging studies (computed tomography (CT) in 16 patients, magnetic resonance imaging (MRI) in 9 patients and fluorodeoxyglucose (FDG)-positron emission tomography (PET)/CT in 8 patients) were evaluated by 2 radiologists until consensus. The location, size and imaging features of the primary tumor and metastases at presentation, if any, were recorded, and correlated with clinical data and pathologic features (histologic type, presence of necrosis, mitotic activity, risk category, immunohistochemical profile).

Results: The mean tumor size was 6.9 × 6.0 cm. Of the 16 tumors, 11 (68.7%) were infralevator, 4 (25%) supra and infralevator and 1 (6.3%) supralevator; 9 (56.2%) were exophytic, 6 (37.5%) both exophytic and intraluminal, and 1 (6.3%) was intraluminal. The tumors were iso- to minimally hypoattenuating to muscle on CT, iso- to minimally hypointense on T1-weighted images, hyperintense on T2-weighted images and showed variable enhancement. Necrosis was seen in 4 (25%), and hemorrhage and calcification in 2 (12.5%) patients each. The tumors were FDG avid with a mean maximum standardized uptake value of 11 (8.4-16.8). All tumors were positive for KIT and CD34. Distant metastasis to liver was seen in 1 patient (6.3%) at presentation.

Conclusion: Anorectal GISTs are well-circumscribed, non-circumferential, predominantly infralevator, intramural or exophytic, FDG-avid, hypoattenuating masses, and present without lymphadenopathy or intestinal obstruction.

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A 62-year-old man with rectal GIST. Fused FDG-PET/CT image in the axial plane shows a large intensely FDG-avid mass (arrow) closely abutting and displacing the rectum (arrowhead). Physiologic FDG activity is seen in the urinary bladder.
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Figure 4: A 62-year-old man with rectal GIST. Fused FDG-PET/CT image in the axial plane shows a large intensely FDG-avid mass (arrow) closely abutting and displacing the rectum (arrowhead). Physiologic FDG activity is seen in the urinary bladder.

Mentions: Of the 8 patients who underwent pretreatment FDG-PET/CT, all of the tumors demonstrated moderate to intense FDG uptake (Fig. 4). Maximal standardized uptake values (SUVmax) ranged from 8.4 to 16.8, with a mean value of 11. In 1 patient, in addition to the FDG-avid primary rectal mass (SUVmax 9.2), an FDG-avid lesion with an SUVmax of 8.4 was seen in the left lobe of the liver, which was pathologically proved to be a metastasis.Figure 4


Imaging features of primary anorectal gastrointestinal stromal tumors with clinical and pathologic correlation.

Koch MR, Jagannathan JP, Shinagare AB, Krajewski KM, Raut CP, Hornick JL, Ramaiya NH - Cancer Imaging (2013)

A 62-year-old man with rectal GIST. Fused FDG-PET/CT image in the axial plane shows a large intensely FDG-avid mass (arrow) closely abutting and displacing the rectum (arrowhead). Physiologic FDG activity is seen in the urinary bladder.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3569670&req=5

Figure 4: A 62-year-old man with rectal GIST. Fused FDG-PET/CT image in the axial plane shows a large intensely FDG-avid mass (arrow) closely abutting and displacing the rectum (arrowhead). Physiologic FDG activity is seen in the urinary bladder.
Mentions: Of the 8 patients who underwent pretreatment FDG-PET/CT, all of the tumors demonstrated moderate to intense FDG uptake (Fig. 4). Maximal standardized uptake values (SUVmax) ranged from 8.4 to 16.8, with a mean value of 11. In 1 patient, in addition to the FDG-avid primary rectal mass (SUVmax 9.2), an FDG-avid lesion with an SUVmax of 8.4 was seen in the left lobe of the liver, which was pathologically proved to be a metastasis.Figure 4

Bottom Line: The tumors were FDG avid with a mean maximum standardized uptake value of 11 (8.4-16.8).All tumors were positive for KIT and CD34.Distant metastasis to liver was seen in 1 patient (6.3%) at presentation.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA.

ABSTRACT

Purpose: To evaluate the imaging features of anorectal gastrointestinal stromal tumors (GISTs) with clinical and histopathologic correlation.

Materials and methods: In this Institutional Review Board-approved, Health Insurance Portability and Accountability Act-compliant retrospective study, 16 patients (12 men; mean age 66 years (30-89 years)) with pathologically proven anorectal GISTs seen at our institution from January 2001 to July 2011 were identified. Electronic medical records were reviewed to obtain clinical data. Pretreatment imaging studies (computed tomography (CT) in 16 patients, magnetic resonance imaging (MRI) in 9 patients and fluorodeoxyglucose (FDG)-positron emission tomography (PET)/CT in 8 patients) were evaluated by 2 radiologists until consensus. The location, size and imaging features of the primary tumor and metastases at presentation, if any, were recorded, and correlated with clinical data and pathologic features (histologic type, presence of necrosis, mitotic activity, risk category, immunohistochemical profile).

Results: The mean tumor size was 6.9 × 6.0 cm. Of the 16 tumors, 11 (68.7%) were infralevator, 4 (25%) supra and infralevator and 1 (6.3%) supralevator; 9 (56.2%) were exophytic, 6 (37.5%) both exophytic and intraluminal, and 1 (6.3%) was intraluminal. The tumors were iso- to minimally hypoattenuating to muscle on CT, iso- to minimally hypointense on T1-weighted images, hyperintense on T2-weighted images and showed variable enhancement. Necrosis was seen in 4 (25%), and hemorrhage and calcification in 2 (12.5%) patients each. The tumors were FDG avid with a mean maximum standardized uptake value of 11 (8.4-16.8). All tumors were positive for KIT and CD34. Distant metastasis to liver was seen in 1 patient (6.3%) at presentation.

Conclusion: Anorectal GISTs are well-circumscribed, non-circumferential, predominantly infralevator, intramural or exophytic, FDG-avid, hypoattenuating masses, and present without lymphadenopathy or intestinal obstruction.

Show MeSH
Related in: MedlinePlus