{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T20:26:05Z","timestamp":1791231965681,"version":"4.1.0"},"reference-count":36,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2014,7,16]],"date-time":"2014-07-16T00:00:00Z","timestamp":1405468800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J of Clinical Ultrasound"],"published-print":{"date-parts":[[2015,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The aim of this study was to elucidate the histologic and clinical implications of detection of intratumoral vessels on contrast\u2010enhanced endoscopic ultrasonography (CE\u2010EUS) in gastrointestinal stromal tumors (GISTs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Thirteen patients with a GIST, all of whom were referred for surgery, underwent presurgical CE\u2010EUS. The malignant potential, assessed according to the modified Fletcher risk classification system, and the histologic degree of angiogenesis were compared with the presence or absence of intratumoral vessels on CE\u2010EUS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the six tumors with intratumoral vessels observed on CE\u2010EUS, five were intermediate\u2010 or high\u2010risk GISTs, and the remaining seven negative cases were categorized as very low risk or low risk. The presence of intratumoral vessels on CE\u2010EUS was significantly correlated with a higher\u2010risk classification (<jats:italic>p<\/jats:italic>\u2009=\u20090.005). On histologic examination, all GISTs having visualized vessels incorporated vessels of more than 500 \u03bcm in diameter. The large intratumoral vessels of the five intermediate\u2010 or high\u2010risk GISTs lacked elastic fibers, suggesting that they were neovascular in nature. These higher\u2010risk tumors were also found, by immunohistochemical analysis, to have high expression of vascular endothelial growth factor.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Intratumoral vessels observed in GISTs on CE\u2010EUS are correlated with a higher degree of angiogenesis, resulting in higher malignant potential. \u00a9 2014 Wiley Periodicals, Inc. <jats:italic>J Clin Ultrasound<\/jats:italic>, <jats:bold>43<\/jats:bold>:89\u201397, 2015<\/jats:p><\/jats:sec>","DOI":"10.1002\/jcu.22195","type":"journal-article","created":{"date-parts":[[2014,7,16]],"date-time":"2014-07-16T11:20:41Z","timestamp":1405509641000},"page":"89-97","source":"Crossref","is-referenced-by-count":36,"title":["Contrast\u2010enhanced endoscopic ultrasonography can predict a higher malignant potential of gastrointestinal stromal tumors by visualizing large newly formed vessels"],"prefix":"10.1002","volume":"43","author":[{"given":"Yasunobu","family":"Yamashita","sequence":"first","affiliation":[{"name":"Second Department of Internal Medicine Wakayama Medical University 811\u20101 Kimiidera, Wakayama City Wakayama 641\u20100012 Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Kato","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine Wakayama Medical University 811\u20101 Kimiidera, Wakayama City Wakayama 641\u20100012 Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuki","family":"Ueda","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine Wakayama Medical University 811\u20101 Kimiidera, Wakayama City Wakayama 641\u20100012 Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasushi","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Division of Pathology, Department of Clinical 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