Changes in tumor perfusion induced by chemotherapy in bone sarcomas: color Doppler flow imaging compared with contrast-enhanced MR imaging and three-phase bone scintigraphy.
OBJECTIVE
To prospectively evaluate color Doppler flow imaging (CDFI) with spectral analysis versus dynamic gadolinium-enhanced magnetic resonance (MR) imaging and three-phase bone scintigraphy in monitoring the effect of chemotherapy on bone sarcomas.


METHODS
Seventeen osteosarcomas and five Ewing sarcomas were examined with these imaging techniques before and after chemotherapy. Results were compared with the histopathologic response.


RESULTS
Before chemotherapy, high systolic Doppler frequency shifts (DFSs) and/or low-impedance Doppler signals were found in all but one tumor. Resistive indexes (RIs) in tumor-feeding arteries were substantially lower than in contralateral normal arteries. After chemotherapy, DFSs disappeared in five of seven good respondents and remained substantial in all but one poor respondent. RIs increased substantially in all good respondents and decreased or showed minor changes only in all but one poor respondent.


CONCLUSIONS
CDFI with spectral analysis has an advantage over the other two techniques in monitoring the efficacy of chemotherapy in bone sarcomas because of its superior accuracy, noninvasive nature, availability, and low cost.
van der Woude
H J
HJ
Department of Diagnostic Radiology, University Hospital Leiden, The Netherlands.
Bloem
J L
JL
Schipper
J
J
Hermans
J
J
van Eck-Smit
B L
BL
van Oostayen
J
J
Nooy
M A
MA
Taminiau
A H
AH
Holscher
H C
HC
Hogendoorn
P C
PC
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000098:blood supply* / Q000188:drug therapy / Q000453:epidemiology; D001842:Bone and Bones / Q000098:blood supply; D003952:Diagnostic Imaging; D005260:Female; D006801:Humans; D008297:Male; D012516:Osteosarcoma / Q000098:blood supply* / Q000188:drug therapy / Q000453:epidemiology; D011446:Prospective Studies; D012039:Regional Blood Flow / Q000502:physiology; D012512:Sarcoma, Ewing / Q000098:blood supply* / Q000188:drug therapy / Q000453:epidemiology; D012815:Signal Processing, Computer-Assisted