Assessment of histological response of paediatric bone sarcomas using FDG PET in comparison to morphological volume measurement and standardized MRI parameters

作者：Denecke Timm^*; Hundsdoerfer Patrick; Misch Daniel; Steffen Ingo G; Schoenberger Stefan; Furth Christian; Plotkin Michail; Ruf Juri; Hautzel Hubertus; Stoever Brigitte; Kluge Regine; Bierbach Uta; Otto Sylke; Beck James F; Franzius Christiane; Henze Guenter; Amthauer Holger

来源：European Journal of Nuclear Medicine and Molecular Imaging, 2010, 37(10): 1842-1853.

DOI：10.1007/s00259-010-1484-3

• PET
• Paediatric oncology
• Bone sarcoma
• Ewing sarcoma
• Osteosarcoma
• Therapy response

The objective of this study was to evaluate positron emission tomography (PET) using (18)F-fluoro-2-deoxy-D-glucose (FDG) in comparison to volumetry and standardized magnetic resonance imaging (MRI) parameters for the assessment of histological response in paediatric bone sarcoma patients.
FDG PET and local MRI were performed in 27 paediatric sarcoma patients [Ewing sarcoma family of tumours (EWS), n = 16; osteosarcoma (OS), n = 11] prior to and after neoadjuvant chemotherapy before local tumour resection. Several parameters for assessment of response of the primary tumour to therapy by FDG PET and MRI were evaluated and compared with histopathological regression of the resected tumour as defined by Salzer-Kuntschik.
FDG PET significantly discriminated responders from non-responders using the standardized uptake value (SUV) reduction and the absolute post-therapeutic SUV (SUV2) in the entire patient population (a dagger SUV, p = 0.005; SUV2, p = 0.011) as well as in the subgroup of OS patients (a dagger SUV, p = 0.009; SUV2, p = 0.028), but not in the EWS subgroup. The volume reduction measured by MRI/CT did not significantly discriminate responders from non-responders either in the entire population (p = 0.170) or in both subgroups (EWS, p = 0.950; OS, p = 1.000). The other MRI parameters alone or in combination were unreliable and did not improve the results. Comparing diagnostic parameters of FDG PET and local MRI, metabolic imaging showed high superiority in the subgroup of OS patients, while similar results were observed in the population of EWS.
FDG PET appears to be a useful tool for non-invasive response assessment in the group of OS patients and is superior to MRI. In EWS patients, however, neither FDG PET nor volumetry or standardized MRI criteria enabled a reliable response assessment to be made after neoadjuvant treatment.

• 出版日期2010-10