Gastrointestinal Stromal Tumors: Correlation of Multislice CT Findings to Histopathologic Features and Preliminary Validation of New Scoring System

Abstract Purpose: The purpose of this study is to demonstrate the correlation between radiologic and pathologic features of the gastrointestinal stromal tumors. Patients and methods: A retrospective review from 2004 to 2014 identified 50 resected cases of confirmed gastrointestinal stromal tumors (GIST) is done. All these lesions were visualized in the first multi-slice computed tomography (MSCT) investigation. Radiologic and pathologic features were reviewed and compared. A radiologic score with MSCT findings was established. Four levels of risk were defined and compared to the Miettinen-Lasota prognostic classification. Results: Mean patients' age was 57.6 with a sexratio (M/F) of 1.17. Of the 50 GISTs lesions, 29 were located in the stomach (58%), 3 in the duodenum (6%), 16 in the small intestine (32%), one in the rectum and one in the great omentum. MSCT images were evaluated for origin and size of the tumor, as well as growth pattern, density before and after contrast, relationship with adjacent structures, presence of lymph nodes, ascitis and metastasis. The presence of mucosal ulceration, calcification, necrosis, cystic area or hemorrhage into the lesion was emphasized for each case. The histologic equivalent criteria were gathered from histopathology examination review of all specimens. Significant correlation was found for all these findings except the hemorrhage (p = 0.071). A radiologic score of fifteen items variable between 0 and 18 was established. Miettinen risk classification was noted for each lesion. GISTs with very low risk had MSCT score < 4. GIST with low risk had a MSCT score between 5 and 9. GIST with moderate risk had a score between 10 and 14 and those with high risk had an MSCT score between 15 and 18. Significant correlation was found between the radiologic and histopathologic risk classification (p = 0. 001). Conclusion: MSCT is helpful in risk prediction for GIST

Correlation Between the Responses to Growth Hormone (GH) Treatment During Childhood and Adulthood in a Monocentric Cohort of GH-Deficient Patients.

Our aim was to analyze a cohort of patients with childhood-onset growth hormone deficiency (GHD) to evaluate if there is some correlation between the response to GH treatment during childhood and adulthood, respectively. This was an observational retrospective monocentric cohort study of 47 patients treated with GH during childhood and adulthood. Changes in growth parameters during childhood were compared with the increase of IGF-I z-score and other indexes of GH response (body composition, lipid profile) after 1 year of treatment in adulthood. The only significant positive correlation was observed between final growth velocity during the last year of childhood GH treatment and increase in IGF-I z-score in GH-treated adults (r=0.592, p=< 0.01). No correlation was observed between growth-promoting effects of GH as child and metabolic changes induced by GH as adult. We also observed a negative correlation between weight at the end of childhood GH treatment and the IGF-I response during first year of treatment in adults (r=- 0.335, p <0.05). No significant positive correlation could be observed between the main parameters that evaluate response to GH treatment in children and adults. However, the final growth velocity, which may be considered as one of the main criteria of end of GH treatment in children, was identified as parameter that could predict future response to GH treatment in adulthood