In patients with a gastrointestinal stromal tumor (GIST), the risk for malignancy can be evaluated with the use of noninvasive radiomics, according to the results of an analysis published in Frontiers in Oncology.

A retrospective, multicenter study was conducted among patients with a confirmed histopathologic GIST from 5 medical centers in China. Data from computed tomography imaged (CT) images from the participants were collected between January 2015 and August 2021. Data from 2 of the 5 centers were randomly selected and assigned to the training group, and data from the remaining 3 centers were allocated to the validation group.

The investigators sought to explore the diagnostic accuracy of radiomics models based on the enhanced CT images in distinguishing the malignancy risk in GIST, compared with use of the clinical indicators model and traditional CT diagnostic criteria.

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A total of 342 participants aged 33 to 82 years were enrolled in the study; 156 patients were male and 186 were female. The training group comprised 196 patients and the validation group included 146 patients. The GIST lesion was located in the stomach in 226 of the participants and had a nonstomach location in 106 participants, of which 104 were considered cases of potential malignancy (26 extremely low risk; 78 low risk) and 238 were deemed cases of malignancy (86 moderate risk, 152 high risk).

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Following CT image segmentation, along with feature extraction and selection, an arterial phase model and a venous phase model were established. Maximum tumor diameter and internal necrosis were utilized to establish a radiomics clinical indicators model.

Results of the study showed that in the training group, the area under the curves (AUCs) of the arterial phase model, the venous phase model, the clinical indicators model, and the traditional CT diagnostic criteria were 0.930 (95% CI, 0.895-0.965); 0.933 (95% CI, 0.898-0.967); 0.917 (95% CI, 0.872-0.961); and 0.782 (95% CI, 0.717-0.848).

The respective AUCs of the models in the validation group were 0.960 (95% CI, 0.930-0.990); 0.961 (95% CI, 0.930-0.992); 0.922 (95% CI, 0.884-0.960); and 0.768 (95% CI, 0.692-0.844).

Per the DeLong test, no significant difference was observed in the AUCs among the arterial phase model, the venous phase model, and the clinical indicators model. A significant difference was reported, however, between the traditional CT diagnostic criteria and the other 3 models.

According to the investigators, “The morphological radiomic features of GISTs play a significant role in tumor risk stratification and can provide a reference for clinical diagnosis and treatment plan.”

GIST is the most common type of mesenchymal tumor found in the gastrointestinal tracts of middle-aged and elderly individuals. They are most commonly reported in the stomach, small intestine, colorectal region, and esophagus.


Wang Y, Wang Y, Ren J, et al. Malignancy risk of gastrointestinal stromal tumors evaluated with noninvasive radiomics: a multi-center study. Front Oncol. Published online August 17, 2022. doi:10.3389/fonc.2022.966743.