title: A novel combined radiological method for evaluation of the response to chemotherapy for primary bone sarcoma.
abstract: BACKGROUND
  In the treatment of bone sarcoma, evaluation of chemotherapeutic effects is extremely important. In this study, we compared radiological evaluations and histological response, and developed a combined radiological scoring system for assessing the response to chemotherapy.
  
  
  METHODS
  A total of 79 patients with primary bone sarcomas were examined by X-ray photography (Xp), angiography, MRI, 201Tl scintigraphy (Tl) and 99mTc-MIBI scintigraphy (MIBI) to evaluate their response to preoperative chemotherapy. Patients were classified as responders and non-responders according to radiological images. All resected tumors were evaluated histologically and classified as a good response (≥90% necrosis) or a poor response (≤90% necrosis). The sensitivity, specificity, accuracy, and kappa values in radiological evaluation were calculated. Furthermore, we developed a combined radiological scoring system that correlated the results of radiological images with histological response.
  
  
  RESULTS
  Sensitivity, specificity, and accuracy were 90.9%, 38.2%, and 67.5% (K = 0.31), respectively, for Xp; 91.7%, 33.3%, and 66.7% (K = 0.27) for angiography; 81.0%, 67.6%, and 75.0% (K = 0.49) for MRI; 78.9%, 72.4%, and 76.1% (K = 0.51) for Tl; 85.3%, 69.2%, and 78.3% (K = 0.55) for MIBI; and 93.3%, 76.5%, and 86.1% (K = 0.71) for combined radiological scoring.
  
  
  CONCLUSIONS
  Combined radiological evaluations showed high correlation with histological response for assessing the effects of chemotherapy.
authors.affiliation: Department of Orthopaedic Surgery, Kanazawa University School of Medicine, Kanazawa, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Miwa
authors.forename: Junichi
authors.initials: J
authors.lastname: Taki
authors.forename: Norio
authors.initials: N
authors.lastname: Yamamoto
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Shirai
authors.forename: Hideji
authors.initials: H
authors.lastname: Nishida
authors.forename: Katsuhiro
authors.initials: K
authors.lastname: Hayashi
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Tanzawa
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kimura
authors.forename: Akihiko
authors.initials: A
authors.lastname: Takeuchi
authors.forename: Kentaro
authors.initials: K
authors.lastname: Igarashi
authors.forename: Akishi
authors.initials: A
authors.lastname: Ooi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tsuchiya
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D002945:Cisplatin / Q000627:therapeutic use; D003952:Diagnostic Imaging / Q000379:methods*; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals; D012509:Sarcoma / Q000188:drug therapy* / Q000473:pathology*; D012680:Sensitivity and Specificity; D017256:Technetium Tc 99m Sestamibi; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D019275:Radiopharmaceuticals; D004317:Doxorubicin; D017256:Technetium Tc 99m Sestamibi; D002945:Cisplatin