Imaging of malignant tumours of the long bones in children: monitoring response to neoadjuvant chemotherapy and preoperative assessment.
This review focuses on imaging of osteosarcoma and Ewing's sarcoma of the long bones in children during preoperative neoadjuvant chemotherapy. Morphological criteria on plain films and conventional static MRI are insufficiently correlated with histological response. We review the contribution of dynamic MRI, diffusion-weighted MR and nuclear medicine (18FDG-PET) to monitor tumoural necrosis. MRI is currently the best method to evaluate local extension prior to tumour resection, especially to assess the feasibility of conservative surgery. Quantitative models in dynamic MRI and 18FDG-PET are currently being developed in order to find new early prognostic criteria, but for the time being, treatment protocols are still based on the gold standard of histological response.
Brisse
Hervé
H
Imaging Department, Institut Curie, 26 rue d'Ulm, 75005 Paris, France. herve.brisse@curie.net
Ollivier
Liliane
L
Edeline
Véronique
V
Pacquement
Hélène
H
Michon
Jean
J
Glorion
Christophe
C
Neuenschwander
Sylvia
S
D000293:Adolescent; D001859:Bone Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D002648:Child; D006801:Humans; D008279:Magnetic Resonance Imaging; D009336:Necrosis; D012516:Osteosarcoma / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D011300:Preoperative Care; D011379:Prognosis; D012074:Remission Induction; D012512:Sarcoma, Ewing / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D013977:Tibia / Q000000981:diagnostic imaging / Q000187:drug effects / Q000473:pathology; D014055:Tomography, Emission-Computed