European Journal of Nuclear Medicine

, Volume 22, Issue 6, pp 553–555 | Cite as

Quantitative evaluation of thallium-201 uptake in predicting chemotherapeutic response of osteosarcoma

  • Joanna Lin
  • Wai-tong Leung
  • Stephen K. W. Ho
  • K. C. Ho
  • S. M. Kumta
  • Con Metreweli
  • Philip J. Johnson
Short Communication

Abstract

Thallium-201 has been shown to be useful in predicting tumour viability in patients undergoing neoadjuvant chemotherapy for osteogenic sarcoma. Early studies relied upon qualitative assessment of analog images to obtain predictive results. Recently, the lesion to normal tissue uptake ratio of201Tl has been used in evaluating bone and soft tissue sarcomas. This study attempts to quantitate changes in tumour to normal tissue ratio following chemotherapy. Eight consecutive patients with classical osteosarcoma received standard preoperative chemotherapy with a combination of cisplatin, adriamycin and high-dose methotrexate.201Tl gamma scintigraphic images were obtained both before and after chemotherapy. The average counts taken over the tumour divided by that from the contralateral normal tissue area yielded a tumour-to-normal tissue (T/N) ratio. The percentage change in the T/N ratio before and after preoperative chemotherapy was correlated with the percentage of tumour necrosis from pathological section. The median post-chemotherapy T/N ratio was 1.85 (range 0.5–7.7). The median percentage change in T/N ratio after chemotherapy was -58% (range +26% to -83%). The median percentage of necrosis from pathological section was 80% (range 0%–95%). There was a good correlation between the percentage of tumour necrosis and the percentage change in TIN ratio (rank correlation coefficientr=0.84,P=0.0085). Quantitative assessment of changes in 201+1 uptake by osteosarcoma correlates well with tumour necrosis after preoperative chemotherapy. This method may be used to predict response to chemotherapy at an earlier stage, enabling the clinician to consider alternative chemotherapeutic regimens or salvage surgery.

Key words

Osteogenic sarcoma Thallium-201 Chemotherapy 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Rosen G, Caparros B, Huvos AG, et al. Preoperative chemotherapy for osteogenic sarcoma: selection of postoperative adjuvant chemotherapy based upon the response of the primary tumour to preoperative chemotherapy.Cancer 1982; 49: 1221–1230.Google Scholar
  2. 2.
    Caluser I, Abdel-Dayem HM, Homer A, et al. The value of thallium and three-phase bone scans in the evaluation of bone and soft tissue sarcomas.Eur J Nucl Med 1994; 21: 1198–1205Google Scholar
  3. 3.
    Ganz WI, Nguyen TQ, Benedetto MP, et al. Use of early, late and SPECT thallium imaging in evaluating activity of soft tissue and bone tumours [abstract].J Nucl Med 1993; 4: 32pGoogle Scholar
  4. 4.
    Ramanna L, Waxman AD, Waxman S, et al. Tl-201 (Tl) scintigraphy in bone and soft-tissue sarcoma: evaluation of tumour mass and viability.J Nucl Med 1988; 29: 854.Google Scholar
  5. 5.
    Ramanna L, Waxman A, Binney G, Waxman S, Mirra J, Rosen G. Thallium-201 scintigraphy in bone sarcoma: comparison with gallium-67 and technetium-MDP in the evaluation of chemotherapeutic response.J Nucl Med 1990; 31: 567–572.Google Scholar
  6. 6.
    Rosen G, Loren GJ, Brien EW, et al. Serial thallium-201 scintigraphy in osteosarcoma: correlation with tumour necrosis after preoperative chemotherapy.Clin Orthop 1993; 293: 302–306.Google Scholar
  7. 7.
    Menendez LR, Fideler BM, Mirra J. Thallium-201 scanning for the evaluation of osteosarcoma and soft tissue sarcoma.J Bone Joint Surg [Am] 1993; 75: 526–531.Google Scholar
  8. 8.
    Rosen G, Marcove RC, Huvos AG, et al. Primary osteogenic sarcoma: eight-year experience with adjuvant chemotherapy.J Cancer Res Clin Oncol 1983; 106: 55–67.Google Scholar
  9. 9.
    Caluser C, Macapinlac H, Healey J, et al. The relationship between thallium uptake, blood flow, and blood pool activity in bone and soft tissue tumours.Clin Nucl Med 1992; 17: 565–571.Google Scholar
  10. 10.
    Sehweil AM, Mckillop JH, Milroy R, Wilson R, AbdelDayem HM, Omar YT. Mechanism of201Tl uptake in tumours.Eur J Nucl Med 1989; 15: 376–379.Google Scholar

Copyright information

© Springer-Verlag 1995

Authors and Affiliations

  • Joanna Lin
    • 1
  • Wai-tong Leung
    • 1
  • Stephen K. W. Ho
    • 1
  • K. C. Ho
    • 2
  • S. M. Kumta
    • 3
  • Con Metreweli
    • 2
  • Philip J. Johnson
    • 1
  1. 1.Department of Clinical Oncology, Prince of Wales HospitalChinese University of Hong KongShatin, New TerritoriesHong Kong
  2. 2.Department of Diagnostic Radiology and Organ Imaging, Prince of Wales HospitalChinese University of Hong KongShatin, New TerritoriesHong Kong
  3. 3.Department of Orthopaedics and Traumatology, Prince of Wales HospitalChinese University of Hong KongShatin, New TerritoriesHong Kong

Personalised recommendations