Skip to main content
Top
Published in: Skeletal Radiology 9/2012

01-09-2012 | Scientific Article

Value of diffusion-weighted images in differentiating mid-course responders to chemotherapy for osteosarcoma compared to the histological response: preliminary results

Authors: C. Baunin, G. Schmidt, K. Baumstarck, C. Bouvier, J. C. Gentet, A. Aschero, A. Ruocco, B. Bourlière, G. Gorincour, C. Desvignes, N. Colavolpe, G. Bollini, P. Auqier, P. Petit

Published in: Skeletal Radiology | Issue 9/2012

Login to get access

Abstract

Background

Preoperative diffusion-weighted MRI (DW-MRI) has been described as an efficient method to differentiate good and poor responders to chemotherapy in osteosarcoma patients. A DW-MRI performed earlier during treatment could be helpful in monitoring chemotherapy.

Objective

To assess the accuracy of DW-MRI in evaluating response to chemotherapy in the treatment of osteosarcoma, more specifically at mid-course of treatment.

Materials and methods

This study was carried out on a prospective series of adolescents treated for long-bone osteosarcoma. MR examinations were performed at diagnosis (MRI-1), at mid-course of chemotherapy (MRI-2), and immediately before surgery (MRI-3). A DW sequence was performed using diffusion gradients of b0 and b900. The apparent diffusion coefficients (ADC1, ADC2, ADC3, respectively), their differentials (ADC2 − ADC1 and ADC3 − ADC1), and their variation (ADC2 − ADC1/ADC1 and ADC3 − ADC1/ADC1) were calculated for each of these three time points.

Results

Fifteen patients were included. Patients with no increase in ADC showed a poor response to chemotherapy on their histology results. At mid-course, the three calculated values were significantly different between good and poor responders. ADC2 − ADC1 enabled us to detect, with 100% specificity, four out of seven of the poor responders. There was no significant difference in the values at MRI-3 between the two groups.

Conclusion

DW-MRI performed both at baseline and mid-course of neoadjuvant chemotherapy is an efficient method to predict further histological response of osteosarcoma. This method could be used as an early prognostic factor to monitor preoperative chemotherapy.
Literature
1.
go back to reference Bacci G, Longhi A, Versari M, et al. Prognostic factors for osteosarcoma of the extremity treated with neoadjuvantchemotherapy: 15-year experience in 789 patients treated at a single institution. Cancer 2006;106(5):1154–6 Bacci G, Longhi A, Versari M, et al. Prognostic factors for osteosarcoma of the extremity treated with neoadjuvantchemotherapy: 15-year experience in 789 patients treated at a single institution. Cancer 2006;106(5):1154–6
2.
go back to reference Le Deley MC, Guinebretière JM, Gentet JC, Société Française d’Oncologie Pédiatrique (SFOP), et al. SFOP OS94: a randomised trial comparing preoperative high-dose methotrexate plus doxorubicin to high-dose methotrexate plus etoposide and ifosfamide in osteosarcoma patients. Eur J Cancer. 2007;43(4):752–61.PubMedCrossRef Le Deley MC, Guinebretière JM, Gentet JC, Société Française d’Oncologie Pédiatrique (SFOP), et al. SFOP OS94: a randomised trial comparing preoperative high-dose methotrexate plus doxorubicin to high-dose methotrexate plus etoposide and ifosfamide in osteosarcoma patients. Eur J Cancer. 2007;43(4):752–61.PubMedCrossRef
3.
go back to reference Kim MS, Lee SY, Cho WH, et al. Initial tumor size predicts histologic response and survival in localized osteosarcoma patients. J Surg Oncol. 2008;97(5):456-61 Kim MS, Lee SY, Cho WH, et al. Initial tumor size predicts histologic response and survival in localized osteosarcoma patients. J Surg Oncol. 2008;97(5):456-61
4.
go back to reference Bajpai J, Gamnagatti S, Kumar R, et al. Role of MRI in osteosarcoma for evaluation and prediction of chemotherapy response: correlation with histological necrosis. Pediatr Radiol. 2010;41(4):441–50.PubMedCrossRef Bajpai J, Gamnagatti S, Kumar R, et al. Role of MRI in osteosarcoma for evaluation and prediction of chemotherapy response: correlation with histological necrosis. Pediatr Radiol. 2010;41(4):441–50.PubMedCrossRef
5.
go back to reference Bramer JA, van Linge JH, Grimer RJ, et al. Prognostic factors in localized extremity osteosarcoma: a systematic review. Eur J Surg Oncol. 2009;35(10):1030–6.PubMedCrossRef Bramer JA, van Linge JH, Grimer RJ, et al. Prognostic factors in localized extremity osteosarcoma: a systematic review. Eur J Surg Oncol. 2009;35(10):1030–6.PubMedCrossRef
6.
go back to reference 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 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
7.
go back to reference Pan G, Raymond AK, Carrasco CH, Wallace S, et al. Osteosarcoma: MR imaging after preoperative chemotherapy. Radiology. 1990;174:517–26.PubMed Pan G, Raymond AK, Carrasco CH, Wallace S, et al. Osteosarcoma: MR imaging after preoperative chemotherapy. Radiology. 1990;174:517–26.PubMed
8.
go back to reference Holscher HC, Bloem JL, Vanel D, et al. Osteosarcoma: chemotherapy-induced changes at MR imaging. Radiology. 1992;182:839–44.PubMed Holscher HC, Bloem JL, Vanel D, et al. Osteosarcoma: chemotherapy-induced changes at MR imaging. Radiology. 1992;182:839–44.PubMed
9.
go back to reference Van der Woude HJ, Bloem JL, Verstraete KL, et al. Osteosarcoma and Ewing’s sarcoma after neoadjuvent chemotherapy: value of dynamic MR Imaging in detecting viable tumor before surgery. AJR Am J Roentgenol. 1995;165:593–8.PubMed Van der Woude HJ, Bloem JL, Verstraete KL, et al. Osteosarcoma and Ewing’s sarcoma after neoadjuvent chemotherapy: value of dynamic MR Imaging in detecting viable tumor before surgery. AJR Am J Roentgenol. 1995;165:593–8.PubMed
10.
go back to reference Verstraete KL, Van der Woude HJ, et al. Dynamic contrast-enhanced MR imaging of musculoskeletal tumors: basic principles and clinical applications. J Magn Reson Imaging. 1996;6:311–21.PubMedCrossRef Verstraete KL, Van der Woude HJ, et al. Dynamic contrast-enhanced MR imaging of musculoskeletal tumors: basic principles and clinical applications. J Magn Reson Imaging. 1996;6:311–21.PubMedCrossRef
11.
go back to reference Reddick WE, Wang S, Xiong X, et al. Dynamic magnetic resonance Imaging of regional contrast access as an additional prognostic factor in pediatric osteosarcoma. Cancer. 2001;91(12):2230–7.PubMedCrossRef Reddick WE, Wang S, Xiong X, et al. Dynamic magnetic resonance Imaging of regional contrast access as an additional prognostic factor in pediatric osteosarcoma. Cancer. 2001;91(12):2230–7.PubMedCrossRef
12.
go back to reference Dyke JP, Panicek DM, Healey JH, et al. Osteogenic and Ewing sarcomas: estimation of necrotic fraction during induction chemotherapy with dynamic contrast- enhanced MR Imaging. Radiology. 2003;228:271–8.PubMedCrossRef Dyke JP, Panicek DM, Healey JH, et al. Osteogenic and Ewing sarcomas: estimation of necrotic fraction during induction chemotherapy with dynamic contrast- enhanced MR Imaging. Radiology. 2003;228:271–8.PubMedCrossRef
13.
go back to reference Uhl M, Saueressig U, van Buiren M, Kontny U, et al. Osteosarcoma: preliminary results of in vivo assessment of tumor necrosis after chemotherapy with diffusion- and perfusion-weighted magnetic resonance imaging. Invest Radiol. 2006;41(8):618–23.PubMedCrossRef Uhl M, Saueressig U, van Buiren M, Kontny U, et al. Osteosarcoma: preliminary results of in vivo assessment of tumor necrosis after chemotherapy with diffusion- and perfusion-weighted magnetic resonance imaging. Invest Radiol. 2006;41(8):618–23.PubMedCrossRef
14.
go back to reference Ongolo-Zogo P, Thiesse P, Sau J, Desuvinges C, et al. Assessment of osteosarcoma response to neoadjuvent chemotherapy: comparative usefulness of dynamic gadolinium-enhanced spin-echo magnetic resonance imaging and technetium-99 m skeletal angioscintigraphy. Eur Radiol. 1999;9:907–14.PubMedCrossRef Ongolo-Zogo P, Thiesse P, Sau J, Desuvinges C, et al. Assessment of osteosarcoma response to neoadjuvent chemotherapy: comparative usefulness of dynamic gadolinium-enhanced spin-echo magnetic resonance imaging and technetium-99 m skeletal angioscintigraphy. Eur Radiol. 1999;9:907–14.PubMedCrossRef
15.
go back to reference Van Rijswijk CSP, Kunz P, Hogendoorn PCW, et al. Diffusion-weighted MRI in the characterization of soft-tissue tumors. J Magn Reson Imaging. 2002;15:302–7.PubMedCrossRef Van Rijswijk CSP, Kunz P, Hogendoorn PCW, et al. Diffusion-weighted MRI in the characterization of soft-tissue tumors. J Magn Reson Imaging. 2002;15:302–7.PubMedCrossRef
16.
go back to reference Baur A, Huber A, Arbogast S, et al. Diffusion-weighted imaging of tumor recurrencies and posttherapeutical soft-tissue changes in humans. Eur Radiol. 2001;11:828–33.PubMedCrossRef Baur A, Huber A, Arbogast S, et al. Diffusion-weighted imaging of tumor recurrencies and posttherapeutical soft-tissue changes in humans. Eur Radiol. 2001;11:828–33.PubMedCrossRef
17.
go back to reference Baur A, Reiser MF. Diffusion-weighted imaging of the musculoskeletal system in humans. Skeletal Radiol. 2000;29:555–62.PubMedCrossRef Baur A, Reiser MF. Diffusion-weighted imaging of the musculoskeletal system in humans. Skeletal Radiol. 2000;29:555–62.PubMedCrossRef
18.
go back to reference Herneth AM, Friedrich K, Weidekamm C, Schibany N, et al. Diffusion weighted imaging of bone marrow pathologies. Eur J Radiol. 2005;55:74–83.PubMedCrossRef Herneth AM, Friedrich K, Weidekamm C, Schibany N, et al. Diffusion weighted imaging of bone marrow pathologies. Eur J Radiol. 2005;55:74–83.PubMedCrossRef
19.
go back to reference MacKenzie JD, Gonzalez L, Hernandez A. Diffusion-weighted and diffusion tensor imaging for pediatric musculoskeletal disorders. Pediatr Radiol. 2007;37:781–8.PubMedCrossRef MacKenzie JD, Gonzalez L, Hernandez A. Diffusion-weighted and diffusion tensor imaging for pediatric musculoskeletal disorders. Pediatr Radiol. 2007;37:781–8.PubMedCrossRef
20.
go back to reference Nonomura Y, Yasumoto M, Yoshimura R, Haraguchi K, et al. Relationship between bone marrow cellularity and apparent diffusion coefficient. J Magn Reson Imaging. 2001;13:757–60.PubMedCrossRef Nonomura Y, Yasumoto M, Yoshimura R, Haraguchi K, et al. Relationship between bone marrow cellularity and apparent diffusion coefficient. J Magn Reson Imaging. 2001;13:757–60.PubMedCrossRef
21.
go back to reference Humphries PD, Sebire NJ, Siegel MJ, et al. Tumors in pediatric patients at diffusion-weighted MR imaging: apparent diffusion coefficient and tumor cellularity. Radiology. 2007;245(3):848–54.PubMedCrossRef Humphries PD, Sebire NJ, Siegel MJ, et al. Tumors in pediatric patients at diffusion-weighted MR imaging: apparent diffusion coefficient and tumor cellularity. Radiology. 2007;245(3):848–54.PubMedCrossRef
22.
go back to reference Lang P, Wendland MF, Saeed M, Gindele A, Rosenau W. Osteogenic osteosarcoma: non-invasive in vivo assessment of tumor necrosis with diffusion-weighted MR imaging. Radiology. 1998;206:227–35.PubMed Lang P, Wendland MF, Saeed M, Gindele A, Rosenau W. Osteogenic osteosarcoma: non-invasive in vivo assessment of tumor necrosis with diffusion-weighted MR imaging. Radiology. 1998;206:227–35.PubMed
23.
go back to reference Thoeny HC, De Keyser F, Chen F. Diffusion-weighted MR imaging in monitoring the effect of a vascular targeting agent on rhabdomyosarcoma in rats. Radiology. 2005;234:756–64.PubMedCrossRef Thoeny HC, De Keyser F, Chen F. Diffusion-weighted MR imaging in monitoring the effect of a vascular targeting agent on rhabdomyosarcoma in rats. Radiology. 2005;234:756–64.PubMedCrossRef
24.
go back to reference Uhl M, Saueressig U, Koehler G. Evaluation of tumour necrosis during chemotherapy with diffusion-weighted MR imaging: preliminary results in osteosarcomas. Pediatr Radiol. 2006;36:1306–11.PubMedCrossRef Uhl M, Saueressig U, Koehler G. Evaluation of tumour necrosis during chemotherapy with diffusion-weighted MR imaging: preliminary results in osteosarcomas. Pediatr Radiol. 2006;36:1306–11.PubMedCrossRef
25.
go back to reference Hayashida Y, Yakushiji T, Awai K. Monitoring therapeutic responses of primary bone tumors by diffusion-weighted images: initial results. Eur Radiol. 2006;16:2637–43.PubMedCrossRef Hayashida Y, Yakushiji T, Awai K. Monitoring therapeutic responses of primary bone tumors by diffusion-weighted images: initial results. Eur Radiol. 2006;16:2637–43.PubMedCrossRef
26.
go back to reference Oka K, Yakushiji T, Sato H. The value of diffusion-weighted imaging for monitoring the chemotherapeutic response of osteosarcoma: a comparison between average apparent diffusion coefficient and minimum apparent diffusion coefficient. Skeletal Radiol. 2010;39(2):141–6.PubMedCrossRef Oka K, Yakushiji T, Sato H. The value of diffusion-weighted imaging for monitoring the chemotherapeutic response of osteosarcoma: a comparison between average apparent diffusion coefficient and minimum apparent diffusion coefficient. Skeletal Radiol. 2010;39(2):141–6.PubMedCrossRef
27.
go back to reference Denecke T, Hundsdörfer P, Misch D, et al. Assessment of histological response of paediatric bone sarcomas using FDG PET in comparison to morphological volume measurement and standardized MRI parameters. Eur J Nucl Med Mol Imaging. 2010;37(10):1842–53.PubMedCrossRef Denecke T, Hundsdörfer P, Misch D, et al. Assessment of histological response of paediatric bone sarcomas using FDG PET in comparison to morphological volume measurement and standardized MRI parameters. Eur J Nucl Med Mol Imaging. 2010;37(10):1842–53.PubMedCrossRef
28.
go back to reference Costelloe CM, Raymond AK, Fitzgerald NE, et al. Tumor necrosis in osteosarcoma: inclusion of the point of greatest metabolic activity from F-18 FDG PET/CT in the histopathologic analysis. Skeletal Radiol. 2010;39(2):131–40.PubMedCrossRef Costelloe CM, Raymond AK, Fitzgerald NE, et al. Tumor necrosis in osteosarcoma: inclusion of the point of greatest metabolic activity from F-18 FDG PET/CT in the histopathologic analysis. Skeletal Radiol. 2010;39(2):131–40.PubMedCrossRef
29.
go back to reference 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 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
30.
go back to reference Hawkins DS, Conrad EU 3rd, Butrynski JE. [F-18]-fluorodeoxy-D-glucose-positron emission tomography response is associated with outcome for extremity osteosarcoma in children and young adults. Cancer. 2009;115(15):3519-25. Hawkins DS, Conrad EU 3rd, Butrynski JE. [F-18]-fluorodeoxy-D-glucose-positron emission tomography response is associated with outcome for extremity osteosarcoma in children and young adults. Cancer. 2009;115(15):3519-25.
31.
go back to reference Costelloe CM, Macapinlac HA, Madewell JE, et al. 18 F-FDG PET/CT as an indicator of progression-free and overall survival in osteosarcoma. J Nucl Med. 2009;50(3):340–7.PubMedCrossRef Costelloe CM, Macapinlac HA, Madewell JE, et al. 18 F-FDG PET/CT as an indicator of progression-free and overall survival in osteosarcoma. J Nucl Med. 2009;50(3):340–7.PubMedCrossRef
32.
go back to reference Huvos AG, Rosen G, Marcove RC. Primary osteogenic sarcoma: pathologic aspects in 20 patients after treatment with chemotherapy en bloc resection, and prosthetic bone replacement. Arch Pathol Lab Med. 1977;101(1):14–8.PubMed Huvos AG, Rosen G, Marcove RC. Primary osteogenic sarcoma: pathologic aspects in 20 patients after treatment with chemotherapy en bloc resection, and prosthetic bone replacement. Arch Pathol Lab Med. 1977;101(1):14–8.PubMed
Metadata
Title
Value of diffusion-weighted images in differentiating mid-course responders to chemotherapy for osteosarcoma compared to the histological response: preliminary results
Authors
C. Baunin
G. Schmidt
K. Baumstarck
C. Bouvier
J. C. Gentet
A. Aschero
A. Ruocco
B. Bourlière
G. Gorincour
C. Desvignes
N. Colavolpe
G. Bollini
P. Auqier
P. Petit
Publication date
01-09-2012
Publisher
Springer-Verlag
Published in
Skeletal Radiology / Issue 9/2012
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-012-1360-2

Other articles of this Issue 9/2012

Skeletal Radiology 9/2012 Go to the issue