Objective: To evaluate the accuracy and clinical value of endoscopic ultrasonography (EUS) in the diagnosis of gastrointestinal stromal tumors (GIST). Methods: This single-center retrospective study analyzed 100 GIST patients at a tertiary hospital (2022.12– 2025.02). Sample size was justified by pre-experimental results (EUS sensitivity 90%, MSCT 80%, α=0.05, β=0.2) to detect ≥ 10% diagnostic efficacy difference. All patients underwent preoperative EUS and multi-slice spiral computed tomography (MSCT) scans. The diagnostic results of EUS, MSCT, and postoperative pathology were compared. The examination time and detection status were recorded, and diagnostic performance metrics such as sensitivity and specificity, as well as the accuracy rates of localization and qualitative diagnosis, were calculated. Additionally, the imaging characteristics of EUS were analyzed. Results: EUS was significantly superior to MSCT in sensitivity (94.92% vs 88.14%), specificity (87.80% vs 73.17%) and localization accuracy (90.00% vs 68.00%) (p< 0.05). Although the EUS examination time was longer (10.11 ± 2.37 vs 5.96 ± 1.85 min, P< 0.05), However, its ability to recognize the typical features of GIST (hypoechoic mass, clear boundary) is stronger, and the misdiagnosis rate is lower. Conclusion: Clinical decisions should prioritize EUS for initial evaluation of suspected submucosal GISTs, while reserving MSCT for assessing tumor extent and metastasis, balancing diagnostic efficacy with examination time considerations. Keywords: gastrointestinal stromal tumor, endoscopic ultrasonography, diagnostic accuracy, retrospective study, pathological staging
Zhang et al. (Sun,) studied this question.