Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Aug 28, 2020; 26(32): 4729-4738
Published online Aug 28, 2020. doi: 10.3748/wjg.v26.i32.4729
New advances in radiomics of gastrointestinal stromal tumors
Roberto Cannella, Ludovico La Grutta, Massimo Midiri, Tommaso Vincenzo Bartolotta
Roberto Cannella, Ludovico La Grutta, Massimo Midiri, Tommaso Vincenzo Bartolotta, Section of Radiology - BiND, University Hospital “Paolo Giaccone”, Palermo 90127, Italy
Tommaso Vincenzo Bartolotta, Department of Radiology, Fondazione Istituto Giuseppe Giglio, Ct.da Pietrapollastra, Cefalù (Palermo) 90015, Italy
Author contributions: Cannella R and Bartolotta TV wrote and revised the manuscript for important intellectual content; La Grutta L and Midiri M made critical revisions related to important intellectual content of the manuscript; all the Authors approved the final version of the article.
Conflict-of-interest statement: All authors have no any conflict of interests.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Tommaso Vincenzo Bartolotta, MD, PhD, Assistant Professor, Section of Radiology - BiND, University Hospital “Paolo Giaccone”, Via del Vespro 129, Palermo 90127, Italy.
Received: May 28, 2020
Peer-review started: May 28, 2020
First decision: June 4, 2020
Revised: June 16, 2020
Accepted: August 1, 2020
Article in press: August 1, 2020
Published online: August 28, 2020

Gastrointestinal stromal tumors (GISTs) are uncommon neoplasms of the gastrointestinal tract with peculiar clinical, genetic, and imaging characteristics. Preoperative knowledge of risk stratification and mutational status is crucial to guide the appropriate patients’ treatment. Predicting the clinical behavior and biological aggressiveness of GISTs based on conventional computed tomography (CT) and magnetic resonance imaging (MRI) evaluation is challenging, unless the lesions have already metastasized at the time of diagnosis. Radiomics is emerging as a promising tool for the quantification of lesion heterogeneity on radiological images, extracting additional data that cannot be assessed by visual analysis. Radiomics applications have been explored for the differential diagnosis of GISTs from other gastrointestinal neoplasms, risk stratification and prediction of prognosis after surgical resection, and evaluation of mutational status in GISTs. The published researches on GISTs radiomics have obtained excellent performance of derived radiomics models on CT and MRI. However, lack of standardization and differences in study methodology challenge the application of radiomics in clinical practice. The purpose of this review is to describe the new advances of radiomics applied to CT and MRI for the evaluation of gastrointestinal stromal tumors, discuss the potential clinical applications that may impact patients’ management, report limitations of current radiomics studies, and future directions.

Keywords: Gastrointestinal stromal tumors, Radiomics, Texture analysis, Computed tomography, Magnetic resonance imaging, Clinical applications

Core tip: Radiomics researches have demonstrated promising results for the differential diagnosis of gastrointestinal stromal tumors (GISTs) with other gastrointestinal neoplasms in the stomach and duodenum. Excellent performances have been reported for the evaluation of risk status, the preoperative identification of high-risk tumors, and the prediction of prognosis after target therapies. Radiogenomics studies are still lacking, with only initial evidences describing the potential of radiomics for the diagnosis of GISTs without KIT mutations. In this work we review the new advances in radiomics applied to the computed tomography and magnetic resonance imaging of GISTs.