Background: Gastrointestinal Stromal Tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. Accurate pre-operative diagnosis, risk stratification, and genotyping are critical for determining the appropriate surgical approach and targeted therapy (such as Imatinib). However, current methods often rely on invasive postoperative pathology and expensive genetic testing.

Study Objective: The purpose of this study is to develop and validate a multimodal Artificial Intelligence (AI) model that integrates clinical data, CT radiomics (imaging features), and pathomics (digital pathology features) to improve the precision of GIST management.

Study Design: This is a prospective, observational study. The researchers will recruit patients with suspected gastric submucosal tumors who are scheduled for surgery or biopsy at The Fourth Hospital of Hebei Medical University.

Core Tasks: The AI model will be trained to perform three specific tasks:

Diagnosis: Distinguish GISTs from other non-GIST mesenchymal tumors (e.g., leiomyomas, schwannomas).

Risk Assessment: Stratify GISTs into risk categories (e.g., Low vs. High risk) to predict malignant potential.

Genotyping: Predict specific gene mutations (e.g., KIT or PDGFRA mutations) to guide immunotherapy or targeted therapy.

Methodology: Patient data (CT scans, pathology slides, and clinical history) will be collected and analyzed by the AI system. The AI's predictions will be compared against the "Gold Standard" results derived from postoperative pathological examination and Next-Generation Sequencing (NGS). This study is non-interventional; the AI results will not affect the standard of care received by the patients.

Inclusion Criteria:

Age ≥ 18 years, gender not limited.

Clinical diagnosis of gastric submucosal tumor (SMT) or suspected gastrointestinal stromal tumor (GIST) based on gastroscopy or ultrasound.

Scheduled for surgical resection or endoscopic biopsy at the study center.

Standard preoperative contrast-enhanced CT scans are available (performed within 2 weeks prior to surgery).

Patients or their legal guardians have signed the informed consent form.

Exclusion Criteria:

Received neoadjuvant therapy (e.g., Imatinib, chemotherapy, or radiotherapy) prior to surgery/biopsy.

Poor quality of CT images (e.g., severe motion artifacts) affecting radiomics analysis.

Insufficient tissue samples for pathological diagnosis or genetic testing.

Confirmed diagnosis of other primary malignancies.

Incomplete clinical data or lost to follow-up immediately after surgery.

Patients presenting with gastric submucosal tumors (SMTs) who are admitted to the Department of Gastrointestinal Surgery at The Fourth Hospital of Hebei Medical University for surgical or endoscopic treatment. The cohort includes patients with subsequently pathologically confirmed GISTs and other mesenchymal tumors (e.g., leiomyoma, schwannoma).