A novel combined radiological method for evaluation of the response to chemotherapy for primary bone sarcoma

作者：Miwa Shinji; Taki Junichi; Yamamoto Norio; Shirai Toshiharu; Nishida Hideji; Hayashi Katsuhiro; Tanzawa Yoshikazu; Kimura Hiroaki; Takeuchi Akihiko; Igarashi Kentaro; Ooi Akishi; Tsuchiya Hiroyuki^*

来源：Journal of Surgical Oncology, 2012, 106(3): 273-279.

DOI：10.1002/jso.23074

• bone sarcoma
• chemotherapy
• histology
• radiology
• accuracy

Background In the treatment of bone sarcoma, evaluation of chemotherapeutic effects is extremely important. In this study, we compared radiological evaluations and histological response, and developed a combined radiological scoring system for assessing the response to chemotherapy. Methods A total of 79 patients with primary bone sarcomas were examined by X-ray photography (Xp), angiography, MRI, 201Tl scintigraphy (Tl) and 99mTc-MIBI scintigraphy (MIBI) to evaluate their response to preoperative chemotherapy. Patients were classified as responders and non-responders according to radiological images. All resected tumors were evaluated histologically and classified as a good response (%26gt;= 90% necrosis) or a poor response (%26lt;= 90% necrosis). The sensitivity, specificity, accuracy, and kappa values in radiological evaluation were calculated. Furthermore, we developed a combined radiological scoring system that correlated the results of radiological images with histological response. Results Sensitivity, specificity, and accuracy were 90.9%, 38.2%, and 67.5% (K?=?0.31), respectively, for Xp; 91.7%, 33.3%, and 66.7% (K?=?0.27) for angiography; 81.0%, 67.6%, and 75.0% (K?=?0.49) for MRI; 78.9%, 72.4%, and 76.1% (K?=?0.51) for Tl; 85.3%, 69.2%, and 78.3% (K?=?0.55) for MIBI; and 93.3%, 76.5%, and 86.1% (K?=?0.71) for combined radiological scoring. Conclusions Combined radiological evaluations showed high correlation with histological response for assessing the effects of chemotherapy. J. Surg. Oncol. 2012; 106:273279.

• 出版日期2012-9