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European Journal of Nuclear Medicine and Molecular Imaging
Published in: European Journal of Nuclear Medicine and Molecular Imaging 8/2014

01-08-2014 | Original Article

Early response monitoring to neoadjuvant chemotherapy in osteosarcoma using sequential 18 F-FDG PET/CT and MRI

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

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 8/2014

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Abstract

Purpose

We evaluated the potential of sequential fluorine-18 fluorodeoxyglucose (18 F-FDG) positron emission tomography (PET)/computed tomography (CT) and MRI (PET/MRI) after one cycle of neoadjuvant chemotherapy to predict a poor histologic response in osteosarcoma.

Methods

A prospective study was conducted on 30 patients with osteosarcoma treated with two cycles of neoadjuvant chemotherapy and surgery. All patients underwent PET/MRI before, after one cycle, and after the completion of neoadjuvant chemotherapy, respectively. Imaging parameters [maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), total lesion glycolysis (TLG), and tumor volume based on magnetic resonance (MR) images (MRV)] and their % changes were calculated on each PET/MRI data set, and histological responses were evaluated on the postsurgical specimen.

Results

A total of 17 patients (57 %) exhibited a poor histologic response after two cycles of chemotherapy. Unlike the little volumetric change in MRI, PET parameters significantly decreased after one and two cycles of chemotherapy, respectively. After one cycle of chemotherapy, SUVmax, MTV, and TLG predicted the poor responders. Among these parameters, either MTV ≥ 47 mL or TLG ≥ 190 g after one cycle of chemotherapy was significantly associated with a poor histologic response on multivariate logistic regression analysis (OR 8.98, p = 0.039). The sensitivity, specificity, and accuracy of these parameters were 71 %, 85 % and 77 %; and 71 %, 85 % and 77 %, respectively.

Conclusion

The histologic response to neoadjuvant chemotherapy in osteosarcoma can be predicted accurately by FDG PET after one course of chemotherapy. Among PET parameters, MTV and TLG were independent predictors of the histologic response.
Appendix
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Metadata
Title
Early response monitoring to neoadjuvant chemotherapy in osteosarcoma using sequential 18 F-FDG PET/CT and MRI
Authors
Byung Hyun Byun
Chang-Bae Kong
Ilhan Lim
Byung Il Kim
Chang Woon Choi
Won Seok Song
Wan Hyeong Cho
Dae-Geun Jeon
Jae-Soo Koh
Soo-Yong Lee
Sang Moo Lim
Publication date
01-08-2014
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 8/2014
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-014-2746-2

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