Imaging

Gastrointestinal mesenchymal tumor

Preliminary Diagnosis: Gastrointestinal Mesenchymal Tumor

I. What imaging technique is first-line for this diagnosis

  • CT scan of the abdomen and pelvis with PO and IV contrast

II. Describe the advantages and disadvantages of this technique for diagnosis of gastrointestinal mesenchymal tumor.

Advantages

  • Relatively quick

  • Highly sensitive and specific imaging modality in diagnosing a primary pathologic process and detecting any secondary complications

  • May help one to evaluate the gastric mucosa for any evidence of ulcerations or exophytic or submucosal masses

  • May help detail the extent of invasion and infiltration of the neoplastic process

  • May help guide biopsy and treatment

  • Offers exquisite detail of the surrounding anatomic structures including vascular, osseous, lymphatic, and soft tissue

Disadvantages

  • Exposes patients to ionizing radiation

III. What are the contraindications for the first-line imaging technique?

  • May be contraindicated in pregnant patients

IV. What alternative imaging techniques are available?

  • Contrasted fluoroscopic guided upper gastrointestinal examination

  • MR imaging

  • PET/CT

  • Ultrasound

V. Describe the advantages and disadvantages of the alternative techniques for diagnosis of gastrointestinal mesenchymal tumor.

Contrasted fluoroscopic guided upper gastrointestinal examination

Advantages

  • Highly portable

  • Relatively inexpensive imaging modality

  • Better details the mucosa of the gastric neoplasm than other imaging modalities

Disadvantages

  • Less sensitive and specific than other imaging modalities in detailing any primary gastric pathology and any secondary complications

  • May expose patients to a large amount of ionizing radiation

  • Does not guide treatment

  • Highly operator dependent

MR imaging

Advantages

  • Better details the soft tissue extension and infiltration of a primary gastric neoplasm than other imaging modalities

  • Details any marrow involvement

  • Does not expose patients to ionizing radiation

Disadvantages

  • Expensive

  • Time-consuming

  • Requires significant patient cooperation to minimize motion artifact

  • Less adept in detailing the mucosa and any mucosal irregularity compared to companion CT and contrasted fluoroscopic imaging

PET/CT

Advantages

  • Highly sensitive and specific in detecting and detailing any primary gastric abnormality

  • Highly sensitive to the smallest neoplastic process

Disadvantages

  • Highly expensive imaging modality

  • Exposes patients to ionizing radiation

Ultrasound

Advantages

  • Highly portable

  • Fast

  • Relatively inexpensive imaging modality

  • Does not expose patients to ionizing radiation

Disadvantages

  • Highly operator dependent

  • Far less sensitive and specific in detailing and detecting a primary gastric abnormality or detecting any secondary complications

VI. What are the contraindications for the alternative imaging techniques?

Contrasted fluoroscopic guided upper gastrointestinal examination

  • May be contraindicated in pregnant patients

MR imaging

  • Contraindicated in patients with non-MR compatible hardware

PET/CT

  • May be contraindicated in pregnant patients

Ultrasound

  • No specific contraindication to ultrasound exists

You must be a registered member of ONA to post a comment.

Sign Up for Free e-newsletters

Regimen and Drug Listings

GET FULL LISTINGS OF TREATMENT Regimens and Drug INFORMATION

Bone Cancer Regimens Drugs
Brain Cancer Regimens Drugs
Breast Cancer Regimens Drugs
Endocrine Cancer Regimens Drugs
Gastrointestinal Cancer Regimens Drugs
Genitourinary Cancer Regimens Drugs
Gynecologic Cancer Regimens Drugs
Head and Neck Cancer Regimens Drugs
Hematologic Cancer Regimens Drugs
Lung Cancer Regimens Drugs
Other Cancers Regimens
Rare Cancers Regimens
Skin Cancer Regimens Drugs