Article ; Online: Diffusion-weighted imaging in differentiating mid-course responders to chemotherapy for long-bone osteosarcoma compared to the histologic response: an update.
2021 Volume 51, Issue 9, Page(s) 1714–1723
Abstract: Background: Diffusion-weighted imaging (DWI) has been described to correlate with tumoural necrosis in response to preoperative chemotherapy for osteosarcoma.: Objective: To assess the accuracy of DWI in evaluating the response to neoadjuvant ... ...
| Abstract | Background: Diffusion-weighted imaging (DWI) has been described to correlate with tumoural necrosis in response to preoperative chemotherapy for osteosarcoma. Objective: To assess the accuracy of DWI in evaluating the response to neoadjuvant chemotherapy at the mid-course treatment of long-bone osteosarcoma and in predicting survival. Materials and methods: We conducted a prospective single-centre study over a continuous period of 11 years. Consecutive patients younger than 20 years treated with a neoadjuvant regimen for peripheral conventional osteosarcoma were eligible for inclusion. Magnetic resonance imaging (MRI) with DWI was performed at diagnosis, and mid- and end-course chemotherapy with mean apparent diffusion coefficients (ADC) calculated at each time point. A percentage less than or equal to 10% of the viable residual tissue at the histological analysis of the surgical specimen was defined as a good responder to chemotherapy. Survival comparisons were calculated using the Kaplan-Meier method. Uni- and multivariate analyses with ADC change were performed by Cox modelling. This is an expansion and update of our previous work. Results: Twenty-six patients between the ages of 4.8 and 19.6 years were included, of whom 14 were good responders. At mid-course chemotherapy, good responders had significantly higher mean ADC values (P=0.046) and a higher increase in ADC (P=0.015) than poor responders. The ADC change from diagnosis to mid-course MRI did not appear to be a prognosticator of survival and did not impact survival rates of both groups. Conclusion: DWI at mid-course preoperative chemotherapy for osteosarcoma should be considered to evaluate the degree of histological necrosis and to predict survival. The anticipation of a response to neoadjuvant treatment by DWI may have potential implications on preoperative management. |
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| MeSH term(s) | Adolescent ; Adult ; Bone Neoplasms/diagnostic imaging ; Bone Neoplasms/drug therapy ; Child ; Child, Preschool ; Diffusion Magnetic Resonance Imaging ; Humans ; Osteosarcoma/diagnostic imaging ; Osteosarcoma/drug therapy ; Prospective Studies ; Treatment Outcome ; Young Adult |
| Language | English |
| Publishing date | 2021-04-20 |
| Publishing country | Germany |
| Document type | Journal Article |
| ZDB-ID | 124459-0 |
| ISSN | 1432-1998 ; 0301-0449 |
| ISSN (online) | 1432-1998 |
| ISSN | 0301-0449 |
| DOI | 10.1007/s00247-021-05037-4 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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