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Correlation between apparent diffusion coefficient and histopathology subtypes of osteosarcoma after neoadjuvant
Jifei Wang1, Meili Sun2, Dawei Liu3
11 Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, PR China.
Acta Radiologica (Stockholm, Sweden : 1987)
|November 18, 2016
Summary
Diffusion-weighted imaging (DWI) can assess osteosarcoma treatment response by measuring apparent diffusion coefficient (ADC) values. DWI effectively differentiates viable tumor from necrosis in osteoblastic and fibroblastic subtypes, but struggles with chondroblastic tumors.
Area of Science:
- Oncology
- Radiology
- Medical Imaging
Background:
- Neoadjuvant chemotherapy enables limb-salvage surgery for osteosarcoma patients.
- Diffusion-weighted magnetic resonance imaging (DWI) is utilized for monitoring chemotherapy response.
Purpose of the Study:
- To correlate apparent diffusion coefficient (ADC) values with histopathology subtypes of osteosarcoma following neoadjuvant chemotherapy.
Main Methods:
- Twelve osteosarcoma patients (7 osteoblastic, 4 chondroblastic, 1 fibroblastic) underwent post-chemotherapy DWI before surgery.
- ADC values from 127 histological tissue samples were compared with histological features.
Main Results:
- Mean ADC values were significantly lower in non-cartilaginous viable tumor (1.22 × 10-3 mm2/s) compared to necrosis (1.77 × 10-3 mm2/s), viable cartilaginous tumor (2.19 × 10-3 mm2/s), and cystic areas (2.29 × 10-3 mm2/s) (P < 0.001).
- Non-cartilaginous tumor cell necrosis showed significantly lower ADC than viable cartilaginous tumor and cystic/hemorrhagic necrosis (P < 0.001).
- No significant ADC difference was found between viable cartilaginous tumor and cystic/hemorrhagic necrosis (P > 0.05).
Conclusions:
- DWI can assess tumor necrosis post-neoadjuvant chemotherapy in osteoblastic and fibroblastic osteosarcomas by differentiating viable tumor from necrosis.
- Viable chondroblastic osteosarcoma exhibits high ADC, making it difficult to reliably distinguish from necrosis using DWI.
