Top

Skeletal Radiology

Published in:

01-08-2011 | Scientific Article

¹⁸F-FDG PET response to neoadjuvant chemotherapy for Ewing sarcoma and osteosarcoma are different

Authors: Louie L. Gaston, Claudia Di Bella, John Slavin, Rodney J. Hicks, Peter F. M. Choong

Published in: Skeletal Radiology | Issue 8/2011

Abstract

Objective

Ewing sarcoma (ES) and osteosarcoma (OS) have different biological characteristics and respond differently to chemotherapy. We reviewed ¹⁸F-FDG PET imaging characteristics of ES and OS patients at baseline and following treatment to determine whether this biological variation is reflected in their imaging phenotype.

Materials and methods

A retrospective review of ES and OS patients treated with neoadjuvant chemotherapy and surgery was done, correlating PET results with histologic response to chemotherapy.

Results

Change in the maximum standardized uptake value (SUVmax) between baseline and post-treatment scanning was not significantly associated with histologic response for either ES or OS. Metabolic tumor volume (MTV) and the percentage of injected ¹⁸F-FDG dose (%ID) in the primary tumor were found to be different for ES and OS response subgroups. A 50% reduction in MTV (MTV2:1 < 0.5) was found to be significantly associated with favorable histologic response in OS. Using the same criteria for ES incorrectly predicted good responders. Increasing the cut-off values for ES to a 90% reduction in MTV (MTV2:1 < 0.1) resulted in association with favorable histologic response.

Conclusion

Response to neoadjuvant chemotherapy as reflected by changes in PET characteristics should be interpreted differently for ES and OS.

Glasser DB, Lane JM, Huvos AG, et al. Survival, prognosis, and therapeutic response in osteogenic sarcoma: the Memorial Hospital experience. Cancer. 1992;69:698–708.PubMedCrossRef

Wunder JS, Paulian G, Huvos AG, et al. The histological response to chemotherapy as a predictor of the oncological outcome of operative treatment of Ewing sarcoma. J Bone Joint Surg Am. 1998;80:1020–33.PubMedCrossRef

Bielack SS, Kempf-Bielack B, Delling G, et al. Prognostic factors in high-grade osteosarcoma of the extremities or trunk: an analysis of 1,702 patients treated on neoadjuvant cooperative osteosarcoma study group protocols. J Clin Oncol. 2002;20:776–90.PubMedCrossRef

Picci P, Rougraff BT, Bacci G, et al. Prognostic significance of histopathologic response to chemotherapy in nonmetastatic Ewing’s sarcoma of the extremities. J Clin Oncol. 1993;11:1763–9.PubMed

Davis AM, Bell RS, Goodwin PJ. Prognostic factors in osteosarcoma: a critical review. J Clin Oncol. 1994;12:423–31.PubMed

Lin P, Jaffe N, Herzog CE, et al. Chemotherapy response is an important predictor of local recurrence in Ewing sarcoma. Cancer. 2007;109:603–11.PubMedCrossRef

Picci P, Sangiorgi L, Rougraff BT, et al. Relationship of chemotherapy-induced necrosis and surgical margins to local recurrence in osteosarcoma. J Clin Oncol. 1994;12:2699–705.PubMed

Schulte M, Brecht-Krauss D, Werner M, et al. Evaluation of neoadjuvant therapy response of osteogenic sarcoma using FDG PET. J Nucl Med. 1999;40:1637–43.PubMed

Franzius C, Sciuk J, Brinkschmidt C, et al. Evaluation of chemotherapy response in primary bone tumors with F-18 FDG positron emission tomography compared with histologically assessed tumor necrosis. Clin Nucl Med. 2000;25(11):874–81.PubMedCrossRef

10.

Hawkins DS, Rajendran JG, Conrad U, et al. Evaluation of chemotherapy response in pediatric bone sarcomas by [F-18]-fluorodeoxy-D-glucose positron emission tomography. Cancer. 2002;94:3277–84.PubMedCrossRef

11.

Hawkins DS, Schuetze SM, Butrynski JE, et al. [F-18]-fluorodeoxy-D-glucose positron emission tomography predicts outcome for Ewing sarcoma family of tumors. J Clin Oncol. 2005;23:8828–34.PubMedCrossRef

12.

Ye Z, Zhu J, Tian M, et al. Response of osteogenic sarcoma to neoadjuvant therapy: evaluated by 18 F-FDG-PET. Ann Nucl Med. 2008;22:475–80.PubMedCrossRef

13.

Hawkins DS, Conrad EU, Butrynski JE, et al. [F-18]-fluorodeoxy-D-glucose positron emission tomography response is associated with outcome for extremity osteosarcoma in children and young adults. Cancer. 2009;115:3519–25.PubMedCrossRef

14.

Cheon GJ, Kim MS, Lee JA, et al. Prediction model of chemotherapy response in osteosarcoma by 18 F-FDG PET and MRI. J Nucl Med. 2009;50(9):1435–40.PubMedCrossRef

15.

Bestic JM, Peterson JJ, Bancroft LW. Pediatric FDG PET/CT: physiologic uptake, normal variants, and benign conditions. Radiographics. 2009;29(5):1487–500.PubMedCrossRef

16.

Hamada K, Tomita Y, Inoue A, et al. Evaluation of chemotherapy response in osteosarcoma with FDG-PET. Ann Nucl Med. 2009;23(1):89–95.PubMedCrossRef

17.

Charest M, Hickeson M, Lisbona R, Derbekyan V, Turcotte RE. FDG PET/CT imaging in primary osseous and soft tissue sarcomas: a retrospective review of 212 cases. Eur J Nucl Med Mol Imaging 2009. Epub 11 July 2009.

18.

Folpe AL, Lyles RH, Sprouse JT et al. (F-18) fluorodeoxyglucose positron emission tomography as a predictor of pathologic grade and other prognostic variables in bone and soft tissue sarcoma. Clin Cancer Res. 2000;6:1279–87.PubMed

19.

van der Woude HJ, Bloem JL, Hogendoorn PC. Preoperative evaluation and monitoring chemotherapy in patients with high-grade osteogenic and Ewing’s sarcoma: a review of current imaging modalities. Skeletal Radiol. 1998;27:57–71.PubMedCrossRef

20.

Abudu A, Davies AM, Pynsent PB, et al. Tumour volume as a predictor of necrosis after chemotherapy in Ewing sarcoma. J Bone Joint Surg Br. 1999;81:317–22.PubMedCrossRef

21.

Brisse H, Ollivier L, Edeline V, et al. Imaging of malignant tumours of the long bones in children: monitoring response to neoadjuvant chemotherapy and preoperative assessment. Pediatr Radiol. 2004;34:595–605.PubMedCrossRef

22.

Smeland S, Wiebe T, Bohling T, et al. Chemotherapy in osteosarcoma. The Scandinavian Sarcoma Group experience. Acta Orthop Scand Suppl. 2004;75:92–8.PubMed

23.

Ferrari S, Smeland S, Mercuri M, et al. Neoadjuvant chemotherapy with high-dose ifosfamide, high-dose methotrexate, cisplatin, and doxorubicin for patients with localized osteosarcoma of the extremity: a joint study by the Italian and Scandinavian Sarcoma Groups. J Clin Oncol. 2005;23:8845–52.PubMedCrossRef

24.

Smeland S, Muller C, Alvegard TA, et al. Scandinavian Sarcoma Group Osteosarcoma Study SSG VIII: prognostic factors for outcome and the role of replacement salvage chemotherapy for poor histological responders. Eur J Cancer. 2003;39:488–94.PubMedCrossRef

25.

Grier HE, Krailo MD, Tarbell NJ, et al. Addition of ifosfamide and etoposide to standard chemotherapy for Ewing’s sarcoma and primitive neuroectodermal tumor of bone. N Engl J Med. 2003;348:694–701.PubMedCrossRef

26.

Craft A, Cotterill S, Malcolm A, et al. Ifosfamide-containing chemotherapy in Ewing’s sarcoma: the Second United Kingdom Children’s Cancer Study Group and the Medical Research Council Ewing’s Tumor Study. J Clin Oncol. 1998;16:3628–33.PubMed

27.

Moodie K, Cherk MH, Lau E, et al. Evaluation of pulmonary nodules and lung cancer with one-inch crystal gamma coincidence positron emission tomography/CT versus dedicated positron emission tomography/CT. J Med Imaging Radiat Oncol. 2009;53(1):32–9.PubMedCrossRef

28.

Shankar LK, Hoffman JM, Bacharach S, et al. Consensus recommendations for the use of 18 F-FDG PET as an indicator of therapeutic response in patients in National Cancer Institute Trials. J Nucl Med. 2006;47(6):1059–66.PubMed

29.

Lowe VJ, Dunphy FR, Varvares M, et al. Evaluation of chemotherapy response in patients with advanced head and neck cancer using 18F-fluorodeoxyglucose positron emission tomography. Head Neck. 1997;19:666–74.PubMedCrossRef

30.

Schelling M, Avril N, Nahrig J, et al. Positron emission tomography using 18F-fluorodeoxyglucose for monitoring primary chemotherapy in breastcancer. J Clin Oncol. 2000;18:1689–95.PubMed

31.

Smith IC, Welch AE, Hutcheon AW, et al. Positron emission tomography using 18 F-fluoro-deoxy-D-glucose to predict the pathologic response of breast cancer to primary chemotherapy. J Clin Oncol. 2000;18:1676–88.PubMed

32.

Weber WA, Ott K, Becker K, et al. Prediction of response to preoperative chemotherapy in adenocarcinomas of the esophagogastric junction by metabolic imaging. J Clin Oncol. 2001;19:3058–65.PubMed

33.

Eary JF, O’Sullivan F, Powitan Y, et al. Sarcoma tumor FDG uptake measured by PET and patient outcome: a retrospective analysis. Eur J Nucl Med. 2002;29:1149–54.CrossRef

34.

Ott K, Fink U, Becker K, et al. Prediction of response to preoperative chemotherapy in gastric carcinoma by metabolic imaging: results of a prospective trial. J Clin Oncol. 2003;21:4604–10.PubMedCrossRef

35.

Schuetze SM, Rubin BP, Vernon C, et al. Use of positron emission tomography in localized extremity soft tissue Sarcoma treated with neoadjuvant chemotherapy. Cancer. 2005;103:339–48.PubMedCrossRef

36.

Benz MR, Czernin J, Allen-Auerbach MS, et al. FDG-PET/CT imaging predicts histopathologic treatment responses after the initial cycle of neo-adjuvant chemotherapy in high-grade soft-tissue Sarcomas. Clin Cancer Res. 2009;15(8):2856–63.PubMedCrossRef

37.

Young H, Baum R, Cremerius U, et al. Measurement of clinical and subclinical tumour response using [18F]-fluorodeoxyglucose and positron emission tomography: review and 1999 EORTC recommendations. European Organization for Research and Treatment of Cancer (EORTC) PET Study Group. Eur J Cancer. 1999;35(13):1773–82.PubMedCrossRef

38.

Iagaru A, Masamed R, Chawla SP, Menendez LR, Fedenko A, Conti PS. F-18 FDG PET and PET/CT evaluation of response to chemotherapy in bone and soft tissue sarcomas. Clin Nucl Med. 2008;33:8–13.PubMedCrossRef

39.

Picci P, Bacci G, Campanacci M, et al. Histologic evaluation of necrosis in osteosarcoma induced by chemotherapy. Regional mapping of viable and nonviable tumor. Cancer. 1985;56(7):1515–21.PubMedCrossRef

40.

Sommer HJ, Knop J, Heise U, et al. Histomorphometric changes of osteosarcoma after chemotherapy. Correlation with 99mTc methylene diphosphonate functional imaging. Cancer. 1987;59(2):252–8.PubMedCrossRef

Title: 18F-FDG PET response to neoadjuvant chemotherapy for Ewing sarcoma and osteosarcoma are different
Authors: Louie L. Gaston
Claudia Di Bella
John Slavin
Rodney J. Hicks
Peter F. M. Choong
Publication date: 01-08-2011
Publisher: Springer-Verlag
Published in: Skeletal Radiology / Issue 8/2011
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI: https://doi.org/10.1007/s00256-011-1096-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

¹⁸F-FDG PET response to neoadjuvant chemotherapy for Ewing sarcoma and osteosarcoma are different

Abstract

Objective

Materials and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Materials and methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 8/2011

Displaceability of SLAP lesion on shoulder MR arthrography with external rotation position

The relationship between prevalent medial meniscal intrasubstance signal changes and incident medial meniscal tears in women over a 1-year period assessed with 3.0 T MRI

Vaccination-induced myositis with intramuscular sterile abscess formation

Erratum to: A new grading system of lumbar central canal stenosis on MRI: an easy and reliable method

Role of Dynamic MRI in the follow-up of acute Charcot foot in patients with diabetes mellitus

The Delphi method: an efficient procedure to generate knowledge