Gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor in the gastrointestinal tract, with complex biological characteristics and varying risks, and the treatment methods and prognosis of patients with different risks are quite different; therefore, early diagnosis and risk assessment are crucial for its precision treatment. In recent years, CT radiomics, as an emerging imaging technology, can transform traditional CT image features into a large number of data, thereby reflecting the inherent heterogeneity of GIST and even correlating with its gene expression features. This paper reviews the research progress of CT radiomics in the diagnosis and prediction of GIST with the help of machine learning. The current CT radiomics can not only be used for the differential diagnosis of GIST and other gastric diseases, but also for the risk evaluation of GIST. Furthermore, pathological analysis and gene diagnosis can be performed based on CT images, and then the first-line treatment effect and long-term prognosis can be predicted. At present, various prediction models constructed by combination of CT radiomics and clinical information have been well verified in the specific practice of different clinical problems, showing broad application prospects. However, in the specific clinical application process, different methods of sample data collection and processing, differences in the selection of machine learning algorithms, and the selection of 2D or 3D images all affect the specific effectiveness of CT radiomics. Hence, unified and standardized application rules for radiomics has to be established.
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