Journal of the Chinese Medical Association
Volume 69, Issue 8 , Pages 372-376, August 2006

Comparison Between F-18-FDG Positron Emission Tomography and Histology for the Assessment of Tumor Necrosis Rates in Primary Osteosarcoma

  • Teng-Le Huang

      Affiliations

    • Department of Orthopedics, China Medical University and University Hospital, Taichung, Taiwan, R.O.C.
    • National Yang-Ming University School of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
    • ,
  • Ren-Shyan Liu

      Affiliations

    • National Yang-Ming University School of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
    • Department of Nuclear Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
    • ,
  • Tain-Hsiung Chen

      Affiliations

    • National Yang-Ming University School of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
    • Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
    • ,
  • Winby York-Kwan Chen

      Affiliations

    • National Yang-Ming University School of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
    • Department of Pathology, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
    • ,
  • Horng-Chaung Hsu

      Affiliations

    • Department of Orthopedics, China Medical University and University Hospital, Taichung, Taiwan, R.O.C.
    • Corresponding Author InformationCorrespondence to: Dr Horng-Chaung Hsu, Department of Orthopedics, China Medical University and University Hospital, 2, Yuh-Der Road, Taichung 404, Taiwan, R.O.C.
    • ,
  • Yen-Chih Hsu

      Affiliations

    • National Yang-Ming University School of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.

Received 6 January 2006; accepted 6 April 2006.

Article Outline

Background

The purpose of this prospective study was to identify if F-18-fluorodeoxy-D-glucose positron emission tomography (F-18-FDG PET) was a reliable noninvasive surrogate of histologic response in determining the efficacy of neoadjuvant chemotherapy before surgical resection in primary osteosarcoma.

Methods

Between January 2003 and December 2003, 10 patients with primary osteosarcomas were examined using F-18-FDG PET before neoadjuvant chemotherapy and surgery. The mean age at the time of first intervention was 19 years (range, 4-47 years). Positive prognostic significance was defined as more than 90% tumor necrosis response following neoadjuvant chemotherapy. The parameters of FDG uptake were correlated with histologic findings. The intraclass correlation coefficient was used to validate the tumor necrosis rates determined by PET and histology.

Results

The tumor necrosis rate determined by PET was comparable with that determined histologically. The mean standardized uptake value before and following neoadjuvant chemotherapy were 8.2 and 4.4, respectively. The average tumor necrosis rate determined by PET was 22%. However, the mean tumor necrosis rate determined histologically was 54.5%. According to the intraclass correlation coefficient models, the intraclass correlation coefficient equaled 0. The relationship of tumor necrosis rates determined by F-18-FDG PET and histology seems to be statistically insignificant.

Conclusion

In this preliminary study, FDG PET did not seem to be a promising tool for evaluating the response of primary osteosarcoma to neoadjuvant chemotherapy.

Key Words:  fluorodeoxy-D-glucose , histology , neoadjuvant chemotherapy , positron emission tomography , sarcoma

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PII: S1726-4901(09)70275-8

doi:10.1016/S1726-4901(09)70275-8

Journal of the Chinese Medical Association
Volume 69, Issue 8 , Pages 372-376, August 2006

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