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

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 wa...

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Bibliographic Details
Published in:European journal of nuclear medicine and molecular imaging 2013-05, Vol.40 (5), p.728-736
Main Authors: Kong, Chang-Bae, Byun, Byung Hyun, Lim, Ilhan, Choi, Chang Woon, Lim, Sang Moo, Song, Won Seok, Cho, Wan Hyeong, Jeon, Dae-Geun, Koh, Jae-Soo, Yoo, Ji Young, Lee, Soo-Yong
Format: Article
Language:English
Subjects:
Adolescent
Adult
Child
Extremities - diagnostic imaging
Female
Fluorodeoxyglucose F18
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Neoadjuvant Therapy
Osteosarcoma - diagnostic imaging
Osteosarcoma - drug therapy
Osteosarcoma - pathology
Positron-Emission Tomography
ROC Curve
Treatment Outcome
Young Adult
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Summary: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. 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. 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 
ISSN:1619-7089
DOI:10.1007/s00259-013-2344-8