Dynamic contrast-enhanced MR imaging evaluation of osteosarcoma response to neoadjuvant chemotherapy.
Assessment of osteosarcoma response to neoadjuvant chemotherapy has prognostic implications, but conventional imaging techniques have been unable to provide an accurate quantitative measure of tumor response. We developed an analysis of dynamic contrast-enhanced MR imaging (DEMRI) to render an image of dynamic vector magnitudes (DVM) and to summarize the result in a quantitative parameter, mean DVM for the lesion (mu DVM). We compared the mu DVM from the examination before surgery with histologic results from an en bloc resection of the tumor in 19 cases. The final mu DVM value provided an accurate (89.5%) measure of tumor necrosis in osteosarcoma. Further, we analyzed the findings in 17 patients with osteosarcoma who completed three DEMRI examinations during the course of therapy. Tumors with higher mu DVM values at presentation had greater decreases in the parameter over the course of therapy. These results are consistent with the distribution of DVM values in these lesions serving as an indicator of tumor perfusion and a possible surrogate variable for drug delivery.
Reddick
W E
WE
Department of Diagnostic Imaging, St. Jude Children's Research Hospital Memphis, TN 38101, USA.
Bhargava
R
R
Taylor
J S
JS
Meyer
W H
WH
Fletcher
B D
BD
D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D001842:Bone and Bones / Q000187:drug effects / Q000473:pathology / Q000601:surgery; D016190:Carboplatin / Q000008:administration & dosage; D017024:Chemotherapy, Adjuvant; D002648:Child; D003131:Combined Modality Therapy; D003287:Contrast Media; D004338:Drug Combinations; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008536:Meglumine; D015080:Mesna / Q000008:administration & dosage; D009336:Necrosis; D009942:Organometallic Compounds; D012516:Osteosarcoma / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D004369:Pentetic Acid / Q000031:analogs & derivatives; D016896:Treatment Outcome
D003287:Contrast Media; D004338:Drug Combinations; D009942:Organometallic Compounds; D008536:Meglumine; D004369:Pentetic Acid; D016190:Carboplatin; D019786:Gadolinium DTPA; D015080:Mesna; D007069:Ifosfamide