Assessment of Chemotherapy Response Using FDG-PET in Pediatric Bone Tumors: A Single Institution Experience
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose Response to neo-adjuvant chemotherapy is an important prognostic factor for osteosarcoma (OS) and the Ewing sarcoma family of tumors (ESFT). [F-18]-fluorodeoxy-D-glucose (FDG)-positron emission tomography (PET) is a non-invasive imaging modality that predicts histologic response to chemotherapy of various malignancies; however, limited data exist about the usefulness of FDG-PET in predicting the histologic response of pediatric bone tumors to chemotherapy. We analyzed the FDG-PET imaging characteristics of pediatric bone tumors and determined the association with response to chemotherapy. Materials and Methods Pediatric patients with OS (n=19) or ESFT (n=17) were evaluated for FDG-PET standard uptake values before (SUV1) and after (SUV2) chemotherapy. The relationship to the chemotherapy response was assessed by histopathology in surgically-excised tumors. A complete data set (SUV1, SUV2, and histologic response) was available in 23 patients. Results While the mean SUV1s were not different between patients with OSs and ESFTs (9.44 vs. 6.07, p=0.24), the SUV2s were greater in the patients with OSs than ESFTs (4.55 vs. 1.66,p=0.01). The ratios of SUV2-to-SUV1 (SUV2 : SUV1) were 0.65 and 0.35 for OS and ESFT, respectively (p=0.08). All of the patients with ESFTs and 47% of the patients with OS had a favorable histologic response to chemotherapy. The SUV2 : 1 [(SUV1-SUV2)/SUV1]≥0.5 and SUV2≤2.5 were related to favorable histologic responses to chemotherapy; the sensitivity and specificity of SUV2 : 1 at 0.5 and SUV2 at 2.5 were 93% and 88%, and 88% and 78%,respectively. Conclusion FDG-PET can be used as a non-invasive surrogate to predict response to chemotherapy in children with bone tumors.
Abstract
Purpose Response to neo-adjuvant chemotherapy is an important prognostic factor for osteosarcoma (OS) and the Ewing sarcoma family of tumors (ESFT). [F-18]-fluorodeoxy-D-glucose (FDG)-positron emission tomography (PET) is a non-invasive imaging modality that predicts histologic response to chemotherapy of various malignancies; however, limited data exist about the usefulness of FDG-PET in predicting the histologic response of pediatric bone tumors to chemotherapy. We analyzed the FDG-PET imaging characteristics of pediatric bone tumors and determined the association with response to chemotherapy. Materials and Methods Pediatric patients with OS (n=19) or ESFT (n=17) were evaluated for FDG-PET standard uptake values before (SUV1) and after (SUV2) chemotherapy. The relationship to the chemotherapy response was assessed by histopathology in surgically-excised tumors. A complete data set (SUV1, SUV2, and histologic response) was available in 23 patients. Results While the mean SUV1s were not different between patients with OSs and ESFTs (9.44 vs. 6.07, p=0.24), the SUV2s were greater in the patients with OSs than ESFTs (4.55 vs. 1.66,p=0.01). The ratios of SUV2-to-SUV1 (SUV2 : SUV1) were 0.65 and 0.35 for OS and ESFT, respectively (p=0.08). All of the patients with ESFTs and 47% of the patients with OS had a favorable histologic response to chemotherapy. The SUV2 : 1 [(SUV1-SUV2)/SUV1]≥0.5 and SUV2≤2.5 were related to favorable histologic responses to chemotherapy; the sensitivity and specificity of SUV2 : 1 at 0.5 and SUV2 at 2.5 were 93% and 88%, and 88% and 78%,respectively. Conclusion FDG-PET can be used as a non-invasive surrogate to predict response to chemotherapy in children with bone tumors.
참고문헌 (19)
- -fluorodeoxy-D-glucose positron emission tomography, "Cancer", 2002, 3277~3284
- Link MP, "The effect of adjuvant chemotherapy on relapse-free survival in patients with osteosarcoma of the extremity", N Engl J Med, 314, pp.1600~1606 (1986)
- Rosen G, "Primary osteogenic sarcoma: the rationale for preoperative chemotherapy and delayed surgery", Cancer, 43, pp.2163~2177 (1979)
- Smith J, "Radiographic changes in primary osteogenic sarcoma following intensive chemotherapy. Radiological-pathological correlation in 63 patients", Radiology, 143, pp.355~360 (1982)
- Hamada K, "Evaluation of chemotherapy response in osteosarcoma with FDG-PET", Ann Nucl Med, 23, pp.89~95 (2009)
- Bombardieri E, "FDG-PET: procedure guidelines for tumour imaging", Eur J Nucl Med Mol Imaging, 30, pp.BP115~BP124 (2003)
- Abouzied MM, "18F-FDG imaging: pitfalls and artifacts", J Nucl Med Technol, 33, pp.145~155 (2005)
- fluorodeoxyglucose positron emission tomography, "J Clin Oncol", 2006, 5366~5372
- Bassa P, "Evaluation of preoperative chemotherapy using PET with fluorine-18-fluorodeoxyglucose in breast cancer", J Nucl Med, 37, pp.931~938 (1996)
- fluorodeoxyglucose positron emission tomography, "Head Neck", 1997, 666~674
- Mikhaeel NG, "FDG-PET after two to three cycles of chemotherapy predicts progression-free and overall survival in highgrade non-Hodgkin lymphoma", Ann Oncol, 16, pp.1514~1523 (2005)
- Kumar R, "Utility of fluorodeoxyglucose-PET imaging in the management of patients with Hodgkin's and non-Hodgkin's lymphomas", Radiol Clin North Am, 42, pp.1083~1100 (2004)
- Gayed I, "The role of 18FFDG PET in staging and early prediction of response to therapy of recurrent gastrointestinal stromal tumors", J Nucl Med, 45, pp.17~21 (2004)
- Boellaard R, "FDG PET and PET", CT: EANM procedure guidelines for tumour PET imaging: version 1.0, 2010, pp.37, 181~200
- Franzius C, "Prognostic significance of (18)F-FDG and (99m)Tc-methylene diphosphonate uptake in primary osteosarcoma", J Nucl Med, 43, pp.1012~1017 (2002)
- Hoekstra OS, "Early treatment response in malignant lymphoma, as determined by planar fluorine- 18-fluorodeoxyglucose scintigraphy", J Nucl Med, 34, pp.1706~1710 (1993)
- Sato J, "Prognostic significance of 18F-FDG uptake in primary osteosarcoma after but not before chemotherapy: a possible association with autocrine motility factor", phosphoglucose isomerase expression, 2008, pp.25, 427~435
- Fluorodeoxyglucose positron emission tomography predicts outcome for Ewing sarcoma family of tumors, "J Clin Oncol", 2005, 8828~8834
- Lewis IJ, "Improvement in histologic response but not survival in osteosarcoma patients treated with intensified chemotherapy: a randomized phase III trial of the European Osteosarcoma Intergroup", J Natl Cancer Inst, 99, pp.112~128 (2007)