Multi-slice CT features predict pathological risk classification in gastric stromal tumors larger than 2 cm: a retrospective multicenter study

Background Accurate risk stratification for gastric stromal tumors (GSTs) has become increasingly important. The Armed Forces Institute of Pathology (AFIP) had higher accuracy and reliability in prognostic assessment and treatment strategies for patients with GSTs. This study aimed to investigate the feasibility of multi-slice CT (MSCT) features of GSTs in predicting AFIP risk classification. Methods Clinical data and MSCT features of 424 patients with solitary GSTs were retrospectively reviewed. According to pathological AFIP risk criteria, 424 GSTs were divided into low-risk group (n = 282), moderate-risk group (n = 72) and high-risk group (n = 70). Clinical data and MSCT features of GSTs were compared among the three groups. Results We found significant differences in tumor location, morphology, necrosis, ulceration, growth pattern, feeding artery, vascular-like enhancement, fat positive sign around GSTs, CT value in venous phase, CT value increment in venous phase, longest diameter, and maximum short diameter (p