Evaluation of tumor blood flow in musculoskeletal lesions: dynamic contrast-enhanced MR imaging and its possibility when monitoring the response to preoperative chemotherapy-work in progress.
OBJECTIVE
The objective of this study was to calculate tumor blood flow (TBF) in musculoskeletal lesions and to evaluate the usefulness of this parameter in differentiating malignant from benign lesions and monitoring the treatment response to preoperative chemotherapy.


METHODS
Altogether, 33 patients with musculoskeletal lesions underwent a total of 50 dynamic magnetic resonance imaging (MRI) examinations, including 28 on 9 patients undergoing preoperative chemotherapy. TBF was calculated using deconvolution analysis. Steepest slope (SS) was determined from the time-intensity curve during the first pass of contrast medium.


RESULTS
TBF ranged from 2.7 to 178.6 mL/100 mL/min in benign lesions and from 15.4 to 296.3 mL/100 mL/min in malignant lesions. SS ranged from 0.5%/s to 31.8%/s for benign lesions and from 3.1%/s to 64.8%/sec for malignant lesions. TBF and SS did not differ significantly between benign and malignant lesions. Among the nine patients who underwent preoperative chemotherapy, TBF after chemotherapy was lower in good responders (11.7, 11.0, 7.9 mL/100 mL/min) (n = 3, tumor necrosis > or =90%) than in poor responders (23.4-141.5 mL/100 mL/min) (n = 6, tumor necrosis <90%).


CONCLUSIONS
TBF and SS cannot reliably differentiate malignant from benign lesions. However, they have potential utility in evaluating the preoperative treatment response in patients with malignant musculoskeletal tumors.
Kajihara
Makoto
M
Department of Radiology, Ehime University School of Medicine, Toon 791-0295, Japan. racoon@kb3.so-net.ne.jp
Sugawara
Yoshifumi
Y
Sakayama
Kenshi
K
Kikuchi
Keiichi
K
Mochizuki
Teruhito
T
Murase
Kenya
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000098:blood supply* / Q000188:drug therapy / Q000473:pathology; D002648:Child; D003287:Contrast Media / Q000008:administration & dosage*; D003937:Diagnosis, Differential; D005260:Female; D019786:Gadolinium DTPA / Q000008:administration & dosage*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019042:Muscle Neoplasms / Q000098:blood supply* / Q000188:drug therapy / Q000473:pathology; D011300:Preoperative Care; D018709:Statistics, Nonparametric
D003287:Contrast Media; D019786:Gadolinium DTPA