Researchers from China developed a new combined radiomic model that can distinguish gastric gastrointestinal stromal tumors (GISTs) from leiomyomas and schwannomas. 

Their new model could assist endoscopic ultrasonography experts in diagnosing subepithelial lesions in a noninvasive manner, especially those that are smaller than 20 mm in diameter, the researchers said. 

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It is difficult to differentiate between GISTs, leiomyomas, and schwannomas using endoscopic ultrasonography. However, it is very important to do so as GISTs can become malignant, while leiomyomas and schwannomas are usually benign.

To develop their model, the team led by Duo-Wu Zou, from the Shanghai Jiao Tong University School of Medicine in Shanghai, China, used 3933 endoscopic ultrasonography images of pathologically confirmed GISTs, leiomyomas, and schwannomas from 5 centers and a total of 485 patients.

The team divided gastric subepithelial lesions into training and testing datasets.

For experts in endoscopic ultrasonography, the accuracy for the differential diagnosis of GISTs from leiomyomas and schwannomas was 74.5%, while sensitivity and specificity were 72.2% and 78.7%, respectively. The area under the receiver operating characteristic curve for endoscopic ultrasonography experts was 0.754.

For the conventional radiomic model, accuracy was 76.8%, sensitivity was 74.4%, specificity was 81%, and the area under the receiver operating characteristic curve was 0.83.

All these values were higher when the combined radiomic model was used with 90.9% accuracy, 91% sensitivity, 90.6% specificity, and 0.953 area under the receiver operating characteristic curve.

The accuracy, specificity, sensitivity, and area under the receiver operating characteristic curve of the combined radiomic model were even higher at 91.4%, 91.1%, 91.6%, and 0.96, respectively, for gastric subepithelial lesions measuring less than 20 mm in diameter. 

“The combined radiomic model showed better diagnostic performance than the conventional radiomic model,” the researchers wrote. 


Zhang XD, Zhang L, Gong TT, et al. A combined radiomic model distinguishing GISTs from leiomyomas and schwannomas in the stomach based on endoscopic ultrasonography images. J Appl Clin Med Phys. Published online May 11, 2023. doi:10.1002/acm2.14023