Findings on energy spectrum CT of gastric-stromal tumor with hepatic metastasis in children: a case report and literature review

Objective: To explore the diagnostic value of energy spectral CT in child with interstitialoma of stomach and hepatic metastasis. Methods: We retrospectively reviewed the clinical and energy spectral CT data of a patient with interstitialoma of stomach and hepatic metastasis, and literatures were reviewed. Results: Energy spectral CT could clearly show both primary interstitialoma of stomach and hepatic metastasis. In the arterial phase (below the 70 keV), the slopes of energy spectral attenuation curves were basically similar among the primary interstitialoma of stomach, normal gastric wall, and hepatic metastasis; while, in the high-energy (above the 80 keV), the three slopes were much more similar. The histogram showed that the energy spectral densities of the primary interstitialoma and the normal gastric wall highly overlapped. However, in scatterplot images, the distribution of energy spectral densities were partially overlapped. The localization of the energy spectral attenuation curves in the arterial and vein phase of the stomach interstitialoma were above the normal gastric wall. The gastric-stromal tumor with hepatic metastasis was confirmed by pathological analysis. Conclusion: The energy spectral CT can exactly identify the homology between the primary and metastasis by the degree of overlapping in spectral curve, histogram, and scatterplot, and can be used to preliminary classify the tumor by comparing monoenergetic spectral attenuation curves. (authors)