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01-07-2019 | osteosarcoma | Nuclear Medicine

Can pretreatment ¹⁸F-FDG PET tumor texture features predict the outcomes of osteosarcoma treated by neoadjuvant chemotherapy?

Authors: Hongjun Song, Yining Jiao, Weijun Wei, Xuhua Ren, Chentian Shen, Zhongling Qiu, Qingcheng Yang, Qian Wang, Quan-Yong Luo

Published in: European Radiology | Issue 7/2019

Abstract

Purpose

To investigate whether tumor texture features derived from pretreatment with ¹⁸F-fluorodeoxyglucose positron emission tomography (FDG PET) can predict histological response or event-free survival (EFS) in patients with localized osteosarcoma of the extremities treated by neoadjuvant chemotherapy (NAC).

Methods

We retrospectively reviewed 35 patients with American Joint Committee on Cancer stage II extremity osteosarcoma treated with NAC and surgery. Primary tumor traditional parameters and texture features were measured for all ¹⁸F-FDG PET images prior to treatment. After surgery, histological responses to NAC were evaluated on the postsurgical specimens. A receiver operating characteristic curve (ROC) was constructed to evaluate the optimal predictive performance among the various indices. EFS was calculated using the Kaplan-Meier method and prognostic significance was assessed by Cox proportional hazards analysis.

Results

Pathologic examination revealed 16 (45.71%) good responders and 19 (54.29%) poor responders. Although both the texture features (least axis, dependence nonuniformity, run length nonuniformity, and size zone nonuniformity) and metabolic tumor volume (MTV) can predict tumor response of osteosarcoma to NAC, the traditional indicator MTV has the best performance according to ROC curve analysis (area under the curve = 0.918, p < 0.0001). In multivariate analysis, MTV (p < 0.0001), histological response (p = 0.0003), and texture feature of coarseness_NGTDM (neighboring gray tone difference matrix) (p = 0.005) were independently associated with EFS.

Conclusions

Intratumoral heterogeneity of baseline ¹⁸F-FDG uptake measured by PET texture analysis can predict tumor response and EFS of patients with extremity osteosarcoma treated by NAC, but the conventional parameter MTV provides better predictive power and is a strong independent prognostic factor.

Key Points

• The baseline ¹⁸ F-FDG PET tumor texture features can predict tumor NAC response for patients with osteosarcoma.

• Coarseness _NGTDM is a new and independent prognostic factor for osteosarcoma.

• MTV provides the best predictive power and is a strong independent prognostic factor for patients with osteosarcoma.

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Title: Can pretreatment 18F-FDG PET tumor texture features predict the outcomes of osteosarcoma treated by neoadjuvant chemotherapy?
Authors: Hongjun Song
Yining Jiao
Weijun Wei
Xuhua Ren
Chentian Shen
Zhongling Qiu
Qingcheng Yang
Qian Wang
Quan-Yong Luo
Publication date: 01-07-2019
Publisher: Springer Berlin Heidelberg
Keywords: osteosarcoma
Osteosarcoma
Positron Emission Tomography
Cytostatic Therapy
Published in: European Radiology / Issue 7/2019
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-019-06074-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Can pretreatment ¹⁸F-FDG PET tumor texture features predict the outcomes of osteosarcoma treated by neoadjuvant chemotherapy?

Abstract

Purpose

Methods

Results

Conclusions

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Key Points

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