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

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

The objective of this study was to evaluate positron emission tomography (PET) using 18F-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.

Methods

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.

Results

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 (∆SUV, p = 0.005; SUV2, p = 0.011) as well as in the subgroup of OS patients (∆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.

Conclusion

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.

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Acknowledgement

This study was financially supported by the Deutsche Krebshilfe e.V. (Grant no. 50-2714-He 1).

Author information

Authors and Affiliations

  1. Klinik für Strahlenheilkunde, Campus Virchow-Klinikum, Charité—Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany

    Timm Denecke, Daniel Misch, Ingo G. Steffen, Michail Plotkin, Brigitte Stöver & Holger Amthauer

  2. Klinik für Pädiatrie m.S. Onkologie und Hämatologie, Otto-Heubner-Zentrum, Campus Virchow-Klinikum, Charité—Universitätsmedizin Berlin, Berlin, Germany

    Patrick Hundsdörfer & Günter Henze

  3. Klinik für Kinder-Onkologie, -Hämatologie und -Immunologie, Universitätsklinikum der Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany

    Stefan Schönberger

  4. Klinik für Radiologie und Nuklearmedizin, Universitätsklinikum Magdeburg A.ö.R., Otto-von-Guericke-Universität Magdeburg, Magdeburg, Germany

    Christian Furth, Juri Ruf & Holger Amthauer

  5. Nuklearmedizinische Klinik, Universitätsklinikum der Heinrich Heine Universität Düsseldorf, Düsseldorf, Germany

    Hubertus Hautzel

  6. Klinik und Poliklinik für Nuklearmedizin, Universitätsklinikum Leipzig A.ö.R., Leipzig, Germany

    Regine Kluge

  7. Abteilung für Kinder-Hämatologie, -Onkologie und -Hämostaseologie, Universitätsklinikum Leipzig A.ö.R., Leipzig, Germany

    Uta Bierbach

  8. Institut für Diagnostische Radiologie und Neuroradiologie, Universitätsklinikum Greifswald, Greifswald, Germany

    Sylke Otto

  9. Abteilung für Pädiatrische Hämatologie und Onkologie, Universitätsklinikum Greifswald, Greifswald, Germany

    James F. Beck

  10. MR- und PET/CT-Zentrum, Bremen-Mitte, Germany

    Christiane Franzius

  11. Klinik und Poliklinik für Nuklearmedizin, Universitätsklinikum Münster, Münster, Germany

    Christiane Franzius

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  1. Timm Denecke
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  2. Patrick Hundsdörfer
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Correspondence to Timm Denecke.

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Timm Denecke and Patrick Hundsdörfer contributed equally to this work.

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Denecke, T., Hundsdörfer, P., Misch, D. et al. Assessment of histological response of paediatric bone sarcomas using FDG PET in comparison to morphological volume measurement and standardized MRI parameters. Eur J Nucl Med Mol Imaging 37, 1842–1853 (2010). https://doi.org/10.1007/s00259-010-1484-3

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  • DOI: https://doi.org/10.1007/s00259-010-1484-3

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