Correspondence: CT Imaging in Gastrointestinal Stromal Tumour: A Case Series TL01-
Dr. Anila Punchiry,
Ceedeeyes Chennaipattinam Flat No. 42-1D, Tiruporur-Guduvanchery Main Road, Ammapettai, Nellikuppam, Chennai-603108, Tamil Nadu, India.
Dear Editor, Authors read with great interest the recent case series titled “CT Imaging in Gastrointestinal Stromal Tumour: A Case Series (1) in the reputed journal. The article has very well-outlined, the importance of Computed Tomography (CT) in imaging the Gastrointestinal Stromal Tumour (GIST). As a resident in a tertiary care centre in the tropical parts of southern India, authors had witnessed numerous cases of GIST on a daily basis. The abstract was well written giving a short idea on the genetical basis of GIST, along with the imaging modalities available and the treatment response and outcome.
However, a few points needs to be added to the already well framed case descriptions. In case-1 the authors have mentioned; the tumour showed areas of necrosis. In our institute we employ the addition of oral contrast images to ascertain the organ of origin. If in case the tumour bed showed communication with the gastric lumen, contrast opacification is noted within, indicating the gastric origin of the tumour. In the article, the differential diagnosis is well written with emphasis on absence of lymphadenopathy which aids in differentiating GIST from its differential contenders. It would have been beneficial to the readers, if other accessory imaging findings of GIST such as an ulcerated mass with internal air-fluid level depicting Torricelli-Bernoulli sign (2) was mentioned.
Although the article is centered mainly around the CT imaging of GIST, a word or two about the added advantage of Magnetic Resonance Imaging (MRI) like diffusion (3), dynamic contrast enhancement pattern could have been included in the discussion part. GIST is one of the well-studied tumours whose genetical basis is completely understood. With advent of Radiomics, the fusion of genetical and imaging features has helped for quantitative evaluation, risk stratification, mutational assessment, malignant potential (4), treatment outcome and response.
Authors would like to congratulate the authors (1) for their successful publication. We understand the limitations of writing the article by keeping within the word limit but, it is our suggestion that with the addition of few above detailed points, the case series would have added more information to the readers.