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European Journal of Nuclear Medicine and Molecular Imaging

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01-05-2013 | Original Article

¹⁸F-FDG PET SUVmax as an indicator of histopathologic response after neoadjuvant chemotherapy in extremity osteosarcoma

Authors: Chang-Bae Kong, Byung Hyun Byun, Ilhan Lim, Chang Woon Choi, Sang Moo Lim, Won Seok Song, Wan Hyeong Cho, Dae-Geun Jeon, Jae-Soo Koh, Ji Young Yoo, Soo-Yong Lee

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 5/2013

Abstract

Purpose

This study evaluated the usefulness of the maximum standardized uptake value (SUVmax) as a measure of histologic response to neoadjuvant chemotherapy in patients with extremity osteosarcoma. The correlation between [¹⁸ F]FDG PET SUVmax values and histologic response to preoperative chemotherapy was also assessed prospectively using PET/MRI.

Methods

A total of 26 consecutive patients with high-grade osteosarcoma were prospectively enrolled. All patients underwent parallel PET and MRI scans before and after neoadjuvant chemotherapy. Using the PET and MRI images and pathologic mapping, we assessed the percentage necrosis by histology at the highest metabolic activity point in the tumors. This was defined as the minimum histologic response. The predictive values of SUVmax before (SUV1) and after (SUV2) chemotherapy and the SUV change ratio were determined. Correlations were also investigated among SUV2, minimum histologic response and histologic response.

Results

Histologically, 13 patients were classified as good responders and 13 as poor responders. Patients with an SUV2 of >5 showed a poor histologic response. A significant correlation was found between SUV2 and histologic response (Spearman’s rho −0.642; P < 0.001), and SUV2 and histologic response were both found to be significantly correlated with minimum histologic response (Spearman’s rho −0.515 and 0.911; P = 0.007 and P < 0.001, respectively).

Conclusion

A SUVmax of more than 5 after neoadjuvant chemotherapy identified the majority of histologic nonresponders (sensitivity 61.3 %, PPV 88.9 %). Tumor necrosis at the point of maximum metabolic activity was found to be significantly correlated with the histologic response of entire resected specimen.

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Title: 18F-FDG PET SUVmax as an indicator of histopathologic response after neoadjuvant chemotherapy in extremity osteosarcoma
Authors: Chang-Bae Kong
Byung Hyun Byun
Ilhan Lim
Chang Woon Choi
Sang Moo Lim
Won Seok Song
Wan Hyeong Cho
Dae-Geun Jeon
Jae-Soo Koh
Ji Young Yoo
Soo-Yong Lee
Publication date: 01-05-2013
Publisher: Springer-Verlag
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 5/2013
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-013-2344-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

¹⁸F-FDG PET SUVmax as an indicator of histopathologic response after neoadjuvant chemotherapy in extremity osteosarcoma

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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