Skeletal Radiology

, Volume 23, Issue 7, pp 493–500 | Cite as

Monitoring the effect of chemotherapy in Ewing's sarcoma of bone with MR imaging

  • H. J. van der Woude
  • J. L. Bloem
  • H. C. Holscher
  • M. A. Nooy
  • A. H. M. Taminiau
  • J. Hermans
  • T. H. M. Falke
  • P. C. W. Hogendoorn


Magnetic resonance (MR) imaging was performed in 26 patients with Ewing's sarcoma of bone preceding and following neoadjuvant chemotherapy, to assess tumour response non-invasively prior to surgery. T1- and T2-weighted spin echo images were obtained. Changes including intra- and extramedullary signal intensities, tumour demarcation, tumour volume and the appearance of residual extramedullary tumour were compared with histopathology of the resected specimens. Reduction of tumour volume was significantly higher in good responders. Other single parameters did not correlate with histologic tumour response. However, when several MR parameters summarized in a classification system were combined, a positive correlation with histopathologic response was found. A limited decrease of tumour volume (<25%) and/or residual soft tissue mass following chemotherapy correlated with a poor response. An inhomogeneous, well-defined cuff of abnormal tissue encircling the bone and/or radiological disappearance of the soft tissue tumour component following chemotherapy correlated with good response. Twenty-three out of 26 patients were correctly classified by MR as good or poor responders. Minimal residual disease (<10% of the entire tumour volume), observed histologically, could not be identified with MR imaging. Tumour volume reduction and residual extramedullary tumour, rather than changes of signal intensity, are major features for evaluating the response to chemotherapy in Ewing's sarcoma.

Key words

Bone tumour Bone neoplasm Ewing's sarcoma MR imaging Chemotherapy 


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Copyright information

© International Skeletal Society 1994

Authors and Affiliations

  • H. J. van der Woude
    • 1
    • 6
  • J. L. Bloem
    • 1
  • H. C. Holscher
    • 1
  • M. A. Nooy
    • 2
  • A. H. M. Taminiau
    • 3
  • J. Hermans
    • 4
  • T. H. M. Falke
    • 5
  • P. C. W. Hogendoorn
    • 6
  1. 1.Department of Diagnostic RadiologyUniversity HospitalLeidenThe Netherlands
  2. 2.Department of Clinical OncologyUniversity HospitalLeidenThe Netherlands
  3. 3.Department of Orthopedic SurgeryUniversity HospitalLeidenThe Netherlands
  4. 4.Department of Medical StatisticsUniversity HospitalLeidenThe Netherlands
  5. 5.Department of Diagnostic RadiologyFree University HospitalAmsterdamThe Netherlands
  6. 6.Department of PathologyUniversity HospitalLeidenThe Netherlands

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