{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T10:53:37Z","timestamp":1774608817311,"version":"3.50.1"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T00:00:00Z","timestamp":1771891200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T00:00:00Z","timestamp":1774569600000},"content-version":"vor","delay-in-days":31,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"DOI":"10.1038\/s41598-026-41599-9","type":"journal-article","created":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T05:05:15Z","timestamp":1771909515000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A novel risk-scoring system based on endoscopic ultrasound and clinical characteristics for the preoperative diagnosis of small gastric gastrointestinal stromal tumors"],"prefix":"10.1038","volume":"16","author":[{"given":"Luojie","family":"Liu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yunfu","family":"Feng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sijie","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bin","family":"He","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chao","family":"Ma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhibing","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaodan","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jian","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying","family":"Shi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,2,24]]},"reference":[{"issue":"2","key":"41599_CR1","doi-asserted-by":"publisher","first-page":"625","DOI":"10.1007\/s10555-021-09961-7","volume":"40","author":"B Al-Share","year":"2021","unstructured":"Al-Share, B. et al. Gastrointestinal stromal tumor: a review of current and emerging therapies. Cancer Metastasis Rev. 40 (2), 625\u2013641. https:\/\/doi.org\/10.1007\/s10555-021-09961-7 (2021). Epub 2021 Apr 19. PMID: 33876372.","journal-title":"Cancer Metastasis Rev."},{"issue":"6","key":"41599_CR2","doi-asserted-by":"publisher","first-page":"906","DOI":"10.1002\/ijc.34052","volume":"151","author":"S Renberg","year":"2022","unstructured":"Renberg, S. et al. The role of neoadjuvant imatinib in gastrointestinal stromal tumor patients: 20 years of experience from a tertial referral center. Int. J. Cancer. 151 (6), 906\u2013913. https:\/\/doi.org\/10.1002\/ijc.34052 (2022). Epub 2022 May 14. PMID: 35478315; PMCID: PMC9545454.","journal-title":"Int. J. Cancer"},{"issue":"4","key":"41599_CR3","doi-asserted-by":"publisher","first-page":"412","DOI":"10.1055\/a-1751-5742","volume":"54","author":"PH Deprez","year":"2022","unstructured":"Deprez, P. H. et al. Endoscopic management of subepithelial lesions including neuroendocrine neoplasms: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy 54 (4), 412\u2013429. https:\/\/doi.org\/10.1055\/a-1751-5742 (2022). Epub 2022 Feb 18. PMID: 35180797.","journal-title":"Endoscopy"},{"issue":"6","key":"41599_CR4","doi-asserted-by":"publisher","first-page":"1132","DOI":"10.1007\/s11605-016-3134-y","volume":"20","author":"TM Coe","year":"2016","unstructured":"Coe, T. M. et al. Population-based epidemiology and mortality of small malignant gastrointestinal stromal tumors in the USA. J. Gastrointest. Surg. 20 (6), 1132\u20131140. https:\/\/doi.org\/10.1007\/s11605-016-3134-y (2016). Epub 2016 Mar 29. PMID: 27025710; PMCID: PMC4880518.","journal-title":"J. Gastrointest. Surg."},{"issue":"1","key":"41599_CR5","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1016\/j.annonc.2021.09.005","volume":"33","author":"PG Casali","year":"2022","unstructured":"Casali, P. G. et al. Electronic address: clinicalguidelines@esmo.org. Gastrointestinal stromal tumours: ESMO-EURACAN-GENTURIS Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann. Oncol. 33 (1), 20\u201333 (2022). Epub 2021 Sep 21. PMID: 34560242.","journal-title":"Ann. Oncol."},{"issue":"5","key":"41599_CR6","doi-asserted-by":"publisher","first-page":"416","DOI":"10.1007\/s10147-008-0798-7","volume":"13","author":"T Nishida","year":"2008","unstructured":"Nishida, T. et al. GIST guideline subcommittee. Clinical practice guidelines for gastrointestinal stromal tumor (GIST) in Japan: English version. Int. J. Clin. Oncol. 13 (5), 416\u2013430. https:\/\/doi.org\/10.1007\/s10147-008-0798-7 (2008). Epub 2008 Oct 23. PMID: 18946752.","journal-title":"Int. J. Clin. Oncol."},{"issue":"19","key":"41599_CR7","doi-asserted-by":"publisher","first-page":"105888","DOI":"10.3748\/wjg.v31.i19.105888","volume":"31","author":"S Shenoy","year":"2025","unstructured":"Shenoy, S. Characterization of subepithelial tumors of upper gastrointestinal tract by endoscopic ultrasound. World J. Gastroenterol. 31 (19), 105888. https:\/\/doi.org\/10.3748\/wjg.v31.i19.105888 (2025). PMID: 40497095; PMCID: PMC12146910.","journal-title":"World J. Gastroenterol."},{"key":"41599_CR8","doi-asserted-by":"publisher","unstructured":"Ma, L. Y. et al. Efficacy and safety of endoscopic intraperitoneal subserosal dissection for gastric submucosal tumors with extraluminal growth pattern. Endoscopy. https:\/\/doi.org\/10.1055\/a-2573-9069 (2025). Epub ahead of print. PMID: 40179965.","DOI":"10.1055\/a-2573-9069"},{"key":"41599_CR9","doi-asserted-by":"publisher","first-page":"106424","DOI":"10.1016\/j.compbiomed.2022.106424","volume":"152","author":"Q He","year":"2023","unstructured":"He, Q. et al. Query2: Query over queries for improving gastrointestinal stromal tumour detection in an endoscopic ultrasound. Comput. Biol. Med. 152, 106424. https:\/\/doi.org\/10.1016\/j.compbiomed.2022.106424 (2023). Epub 2022 Dec 15. PMID: 36543005.","journal-title":"Comput. Biol. Med."},{"key":"41599_CR10","doi-asserted-by":"publisher","unstructured":"Iwahashi, M. et al. Surgical management of small gastrointestinal stromal tumors of the stomach. World J. Surg. 30(1):28\u201335. https:\/\/doi.org\/10.1007\/s00268-005-7944-4 (2006). PMID: 16369707.","DOI":"10.1007\/s00268-005-7944-4"},{"issue":"3","key":"41599_CR11","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1055\/a-1476-8931","volume":"54","author":"X Yang","year":"2022","unstructured":"Yang, X. et al. An artificial intelligence system for distinguishing between gastrointestinal stromal tumors and leiomyomas using endoscopic ultrasonography. Endoscopy 54 (3), 251\u2013261. https:\/\/doi.org\/10.1055\/a-1476-8931 (2022). Epub 2022 Jun 9. PMID: 33827140.","journal-title":"Endoscopy"},{"issue":"2","key":"41599_CR12","doi-asserted-by":"publisher","first-page":"382","DOI":"10.1007\/s10120-021-01261-x","volume":"25","author":"K Hirai","year":"2022","unstructured":"Hirai, K. et al. Artificial intelligence-based diagnosis of upper gastrointestinal subepithelial lesions on endoscopic ultrasonography images. Gastric Cancer. 25 (2), 382\u2013391. https:\/\/doi.org\/10.1007\/s10120-021-01261-x (2022). Epub 2021 Nov 16. PMID: 34783924.","journal-title":"Gastric Cancer"},{"key":"41599_CR13","doi-asserted-by":"publisher","first-page":"102656","DOI":"10.1016\/j.eclinm.2024.102656","volume":"73","author":"Z Dong","year":"2024","unstructured":"Dong, Z. et al. Efficacy of real-time artificial intelligence-aid endoscopic ultrasonography diagnostic system in discriminating gastrointestinal stromal tumors and leiomyomas: a multicenter diagnostic study. EClinicalMedicine 73, 102656. https:\/\/doi.org\/10.1016\/j.eclinm.2024.102656 (2024). PMID: 38828130; PMCID: PMC11137341.","journal-title":"EClinicalMedicine"},{"key":"41599_CR14","doi-asserted-by":"publisher","unstructured":"Ghassemi, M., Oakden-Rayner, L. & Beam, A. L. The false hope of current approaches to explainable artificial intelligence in health care. Lancet Digit Health. 3(11):e745\u2013e750. https:\/\/doi.org\/10.1016\/S2589-7500(21)00208-9 (2021). PMID: 34711379.","DOI":"10.1016\/S2589-7500(21)00208-9"},{"issue":"4","key":"41599_CR15","doi-asserted-by":"publisher","first-page":"590","DOI":"10.1007\/s10120-023-01391-4","volume":"26","author":"M Ni","year":"2023","unstructured":"Ni, M. et al. Risk factors of perforation in gastric stromal tumors during endoscopic resection: a retrospective case-control study. Gastric Cancer. 26 (4), 590\u2013603. https:\/\/doi.org\/10.1007\/s10120-023-01391-4 (2023). Epub 2023 Apr 15. PMID: 37061602.","journal-title":"Gastric Cancer"},{"key":"41599_CR16","doi-asserted-by":"publisher","unstructured":"He, B. et al. Development and validation of an intraoperative perforation prediction scoring system for endoscopic resection of gastric gastrointestinal stromal tumors. Surg. Endosc. https:\/\/doi.org\/10.1007\/s00464-025-12101-9 (2025). Epub ahead of print. PMID: 40835760.","DOI":"10.1007\/s00464-025-12101-9"},{"issue":"4","key":"41599_CR17","doi-asserted-by":"publisher","first-page":"1285","DOI":"10.3390\/cancers15041285","volume":"15","author":"S Pallio","year":"2023","unstructured":"Pallio, S. et al. Endoscopic ultrasound advanced techniques for diagnosis of gastrointestinal stromal tumours. Cancers (Basel). 15 (4), 1285. https:\/\/doi.org\/10.3390\/cancers15041285 (2023). PMID: 36831627; PMCID: PMC9954263.","journal-title":"Cancers (Basel)"},{"issue":"13","key":"41599_CR18","doi-asserted-by":"publisher","first-page":"3158","DOI":"10.3390\/cancers13133158","volume":"13","author":"T Nishida","year":"2021","unstructured":"Nishida, T. et al. Recent progress and challenges in the diagnosis and treatment of gastrointestinal stromal tumors. Cancers (Basel). 13 (13), 3158. https:\/\/doi.org\/10.3390\/cancers13133158 (2021). PMID: 34202544; PMCID: PMC8268322.","journal-title":"Cancers (Basel)"},{"issue":"6","key":"41599_CR19","doi-asserted-by":"publisher","first-page":"872","DOI":"10.5946\/ce.2021.251","volume":"54","author":"SM Kim","year":"2021","unstructured":"Kim, S. M. et al. Predictive factors for differentiating gastrointestinal stromal tumors from leiomyomas based on endoscopic ultrasonography findings in patients with gastric subepithelial tumors: a multicenter retrospective study. Clin. Endosc. 54 (6), 872\u2013880 (2021). Epub 2021 Nov 18. PMID: 34788936; PMCID: PMC8652168.","journal-title":"Clin. Endosc"},{"issue":"7","key":"41599_CR20","doi-asserted-by":"publisher","first-page":"e14023","DOI":"10.1002\/acm2.14023","volume":"24","author":"XD Zhang","year":"2023","unstructured":"Zhang, X. D. et al. A combined radiomic model distinguishing GISTs from leiomyomas and schwannomas in the stomach based on endoscopic ultrasonography images. J. Appl. Clin. Med. Phys. 24 (7), e14023. https:\/\/doi.org\/10.1002\/acm2.14023 (2023). Epub 2023 May 11. PMID: 37166416; PMCID: PMC10338752.","journal-title":"J. Appl. Clin. Med. Phys."},{"key":"41599_CR21","doi-asserted-by":"publisher","unstructured":"Liu, J. et al. Differentiating gastrointestinal stromal tumors from leiomyomas of upper digestive tract using convolutional neural network model by endoscopic ultrasonography. J. Clin. Gastroenterol. 58(6):574\u2013579. https:\/\/doi.org\/10.1097\/MCG.0000000000001907 (2024). PMID: 37646533.","DOI":"10.1097\/MCG.0000000000001907"},{"issue":"5","key":"41599_CR22","doi-asserted-by":"publisher","first-page":"366","DOI":"10.5152\/tjg.2024.22872","volume":"35","author":"C Lv","year":"2024","unstructured":"Lv, C. et al. Application of computer-assisted endoscopic ultrasonography based on texture features in differentiating gastrointestinal stromal tumors from benign gastric mesenchymal tumors. Turk. J. Gastroenterol. 35 (5), 366\u2013373 (2024). PMID: 39128112; PMCID: PMC11181256.","journal-title":"Turk. J. Gastroenterol."},{"issue":"11","key":"41599_CR23","doi-asserted-by":"publisher","first-page":"2435","DOI":"10.1016\/j.cgh.2022.05.054","volume":"20","author":"K Sharzehi","year":"2022","unstructured":"Sharzehi, K., Sethi, A. & Savides, T. AGA Clinical Practice Update on Management of Subepithelial Lesions Encountered During Routine Endoscopy. Expert Rev. Clin. Gastroenterol. Hepatol. ;20(11):2435\u20132443e4. https:\/\/doi.org\/10.1016\/j.cgh.2022.05.054. (2022). Epub 2022 Jul 13. PMID: 35842117.","journal-title":"Expert Rev. Clin. Gastroenterol. Hepatol."},{"issue":"4","key":"41599_CR24","doi-asserted-by":"publisher","first-page":"640","DOI":"10.1016\/j.gie.2022.11.021","volume":"97","author":"YSE Naga","year":"2023","unstructured":"Naga, Y. S. E. et al. Single-incision needle-knife biopsy for the diagnosis of GI subepithelial tumors: a systematic review and meta-analysis. Gastrointest. Endosc. 97 (4), 640\u2013645e2 (2023). Epub 2022 Nov 30. PMID: 36460089.","journal-title":"Gastrointest. Endosc"},{"key":"41599_CR25","doi-asserted-by":"publisher","unstructured":"Cai, M. et al. Automatically optimized radiomics modeling system for small gastric submucosal tumor (<\u20092\u00a0cm) discrimination based on EUS images. Gastrointest Endosc. 9(4):537\u2013547 https:\/\/doi.org\/10.1016\/j.gie.2023.11.006 (2024). e4. Epub 2023 Nov 11. PMID: 37956896.","DOI":"10.1016\/j.gie.2023.11.006"},{"issue":"1","key":"41599_CR26","doi-asserted-by":"publisher","first-page":"46","DOI":"10.14309\/ajg.0000000000002100","volume":"118","author":"BC Jacobson","year":"2023","unstructured":"Jacobson, B. C. et al. ACG clinical guideline: diagnosis and management of gastrointestinal subepithelial lesions. Am. J. Gastroenterol. 118 (1), 46\u201358. https:\/\/doi.org\/10.14309\/ajg.0000000000002100 (2023). Epub 2022 Sep 6. PMID: 36602835.","journal-title":"Am. J. Gastroenterol."},{"issue":"2","key":"41599_CR27","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1016\/j.gie.2021.01.018","volume":"94","author":"IR Cho","year":"2021","unstructured":"Cho, I. R. et al. Comparison of contrast-enhanced versus conventional EUS-guided FNA\/fine-needle biopsy in diagnosis of solid pancreatic lesions: a randomized controlled trial. Gastrointest. Endosc. 94 (2), 303\u2013310 (2021). Epub 2021 Jan 23. PMID: 33497643.","journal-title":"Gastrointest. Endosc"},{"issue":"2","key":"41599_CR28","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1016\/j.gie.2020.06.075","volume":"93","author":"K Krishnan","year":"2021","unstructured":"Krishnan, K. et al; (ASGE Technology Committee Chair, 2016\u20132019); Lichtenstein DR; (ASGE Technology Committee Chair). Enhanced EUS imaging (with videos). Gastrointest. Endosc. 93 (2), 323\u2013333 https:\/\/doi.org\/10.1016\/j.gie.2020.06.075 (2021). Epub 2020 Oct 28. PMID: 33129492.","journal-title":"Gastrointest. Endosc"},{"key":"41599_CR29","doi-asserted-by":"publisher","unstructured":"Tang, J. Y. et al. Value of contrast-enhanced harmonic endoscopic ultrasonography in differentiating between gastrointestinal stromal tumors: a meta-analysis. J. Dig. Dis. 20(3):127\u2013134. https:\/\/doi.org\/10.1111\/1751-2980.12710 (2019). PMID: 30714350.","DOI":"10.1111\/1751-2980.12710"},{"issue":"8","key":"41599_CR30","doi-asserted-by":"publisher","first-page":"6255","DOI":"10.1007\/s00464-023-10106-w","volume":"37","author":"L Liu","year":"2023","unstructured":"Liu, L. et al. Development and validation of a preoperative difficulty scoring system for endoscopic resection of gastric gastrointestinal stromal tumor: a multi-center study. Surg. Endosc. 37 (8), 6255\u20136266. https:\/\/doi.org\/10.1007\/s00464-023-10106-w (2023). Epub 2023 May 16. PMID: 37193892; PMCID: PMC10338596.","journal-title":"Surg. Endosc"},{"issue":"26","key":"41599_CR31","doi-asserted-by":"publisher","first-page":"2806","DOI":"10.3748\/wjg.v24.i26.2806","volume":"24","author":"K Akahoshi","year":"2018","unstructured":"Akahoshi, K. et al. Current clinical management of gastrointestinal stromal tumor. World J. Gastroenterol. 24 (26), 2806\u20132817. https:\/\/doi.org\/10.3748\/wjg.v24.i26.2806 (2018). PMID: 30018476; PMCID: PMC6048423.","journal-title":"World J. Gastroenterol."},{"issue":"3","key":"41599_CR32","doi-asserted-by":"publisher","first-page":"1040","DOI":"10.1007\/s00464-013-3255-2","volume":"28","author":"M Valle","year":"2014","unstructured":"Valle, M. et al. Gastrointestinal stromal tumors of the stomach: the role of laparoscopic resection. Single-centre experience of 38 cases. Surg. Endosc. 28 (3), 1040\u20131047. https:\/\/doi.org\/10.1007\/s00464-013-3255-2 (2014). Epub 2013 Oct 23. PMID: 24149857.","journal-title":"Surg. Endosc"},{"issue":"2","key":"41599_CR33","doi-asserted-by":"publisher","first-page":"217","DOI":"10.5009\/gnl210454","volume":"17","author":"MK Joo","year":"2023","unstructured":"Joo, M. K. et al. Clinical efficacy and safety of endoscopic treatment of gastrointestinal stromal tumors in the stomach. Gut Liver. 17 (2), 217\u2013225. https:\/\/doi.org\/10.5009\/gnl210454 (2023). Epub 2023 Feb 15. PMID: 36789572; PMCID: PMC10018311.","journal-title":"Gut Liver"},{"issue":"1","key":"41599_CR34","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1186\/s12893-023-02164-7","volume":"23","author":"JH Li","year":"2023","unstructured":"Li, J. H. et al. The effect of endoscopic ultrasound on the precise selection of endoscopic treatment for submucosal tumors in the upper gastrointestinal tract. BMC Surg. 23 (1), 255. https:\/\/doi.org\/10.1186\/s12893-023-02164-7 (2023). PMID: 37635257; PMCID: PMC10464286.","journal-title":"BMC Surg."},{"key":"41599_CR35","doi-asserted-by":"publisher","unstructured":"Dong, X. et al. The progression rate and risk factor analysis of small gastric subepithelial tumors: a systematic review and meta-analysis. Surg Endosc. 39(2):730\u2013740.https:\/\/doi.org\/10.1007\/s00464-024-11496-1 (2025). Epub 2025 Jan 3. PMID: 39753931.","DOI":"10.1007\/s00464-024-11496-1"}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-41599-9","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-41599-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-41599-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T09:55:47Z","timestamp":1774605347000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-41599-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,24]]},"references-count":35,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["41599"],"URL":"https:\/\/doi.org\/10.1038\/s41598-026-41599-9","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,24]]},"assertion":[{"value":"1 December 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 February 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 February 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The research protocol received ethical approval from the Institutional Review Board of Changshu Hospital Affiliated to Soochow University (Approval No: L2025055), which served as the central ethics committee for this multi-center study, with additional approvals obtained from the local ethics committees of all other participating institutions. Written informed consent was obtained from all participants.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"10279"}}