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18F-FDG PET SUVmax as an indicator of histopathologic response after neoadjuvant chemotherapy in extremity osteosarcoma
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  • 作者:Chang-Bae Kong (1)
    Byung Hyun Byun (2)
    Ilhan Lim (2)
    Chang Woon Choi (2)
    Sang Moo Lim (2)
    Won Seok Song (1)
    Wan Hyeong Cho (1)
    Dae-Geun Jeon (1)
    Jae-Soo Koh (3)
    Ji Young Yoo (4)
    Soo-Yong Lee (1)
  • 关键词:Osteosarcoma ; FDG PET ; SUVmax ; Histologic response
  • 刊名:European Journal of Nuclear Medicine and Molecular Imaging
  • 出版年:2013
  • 出版时间:May 2013
  • 年:2013
  • 卷:40
  • 期:5
  • 页码:728-736
  • 全文大小:419KB
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  • 作者单位:Chang-Bae Kong (1)
    Byung Hyun Byun (2)
    Ilhan Lim (2)
    Chang Woon Choi (2)
    Sang Moo Lim (2)
    Won Seok Song (1)
    Wan Hyeong Cho (1)
    Dae-Geun Jeon (1)
    Jae-Soo Koh (3)
    Ji Young Yoo (4)
    Soo-Yong Lee (1)

    1. Department of Orthopedic Surgery, Korea Cancer Center Hospital, Seoul, South Korea
    2. Department of Nuclear Medicine, Korea Cancer Center Hospital, 215-4, Gongneung-dong, Nowon-gu, Seoul, 139-706, South Korea
    3. Department of Pathology, Korea Cancer Center Hospital, Seoul, South Korea
    4. Department of Radiology, Korea Cancer Center Hospital, Seoul, South Korea
  • ISSN:1619-7089
文摘
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 ?.642; P-lt;-.001), and SUV2 and histologic response were both found to be significantly correlated with minimum histologic response (Spearman’s rho ?.515 and 0.911; P--.007 and P-lt;-.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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