Related Experiment Video
Updated: Jul 1, 2026
Gene Regulation and Targeted Therapy in Gastric Cancer Peritoneal Metastasis: Radiological Findings from Dual Energy CT and PET/CT
Published on: January 22, 2018
Prognostic Stratification of Standard Responders to Neoadjuvant Chemotherapy in Patients with Osteosarcoma Using
Toshiyuki Takemori1, Eisuke Kobayashi1, Akihiko Yoshida2
1Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center Hospital, Tokyo, Japan.
Introduction:
We aimed to identify a new biomarker using 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) parameters to identify osteosarcoma patients with standard response after neoadjuvant chemotherapy (NAC).
Patients And Materials:
Fifty-four patients with conventional osteosarcoma (age ≤39 years) were included in this study. All patients underwent 18F-FDG PET/CT before (PET1) and after NAC (PET2). We measured PET parameters, including maximum, average, and peak standardized uptake value (SUVmax, SUVave, and SUVpeak); metabolic tumor volume (MTV); and total lesion glycolysis (TLG). Their changes (ΔPET = PET2/PET1) were also examined. The patients were classified into 4 groups based on the histological tumor necrosis rate (TNR): G0 (<50%), G1 (50 to < 90%), G2 (90 to < 100%), and G3 (100%). G0 and G1 patients were enrolled in the standard responder (SR) group (n = 35), while G2 and G3 patients were enrolled in the good responder (GR) group (n = 19). We examined the correlation between changes in each 18F-FDG PET/CT parameter and TNR as well as overall survival (OS) and progression-free survival (PFS) among the 4 groups. In the SR group, the median value of ΔSUVmax was calculated and correlated with prognostic stratification.
Results:
The changes in each PET parameter were correlated with TNR, with SUVpeak showing the strongest correlation. Moreover, in the SR group, there were no differences in OS or PFS between G0 and G1. Patients in the SR group were stratified into 2 groups according to the median ΔSUVmax value (0.62). Patients with ΔSUVmax < 0.62 had significantly better OS (P < 0.01) and PFS (P = 0.02) in comparison with patients with ΔSUVmax ≥ 0.62. In multivariate analyses, ΔSUVmax showed a correlation with OS in the SR group.
Discussion:
This study revealed that ΔSUVmax may confirm the preoperative stratification of the prognosis be a predictive biomarker for patients in the SR group. Moreover, the preoperative identification of patients with a worse prognosis in the SR group has a significant impact on improving the clinical outcomes of patients with osteosarcoma.
Level Of Evidence:
Prognostic studies, Level III. See Instructions for Authors for a complete description of levels of evidence.
More Related Videos
06:51Utilizing 18F-FDG PET/CT Imaging and Quantitative Histology to Measure Dynamic Changes in the Glucose Metabolism in Mouse Models of Lung Cancer
Published on: July 21, 2018
07:54Implantation and Monitoring by PET/CT of an Orthotopic Model of Human Pleural Mesothelioma in Athymic Mice
Published on: December 21, 2019
Related Concept Videos
01:29Positron Emission Tomography
One of the main requirements of a PET scan is a positron-emitting radioisotope, which is produced in a cyclotron and then attached to a substance used by the part of the body being...
01:13Radiological Investigation III: Pulmonary Angiogram and PET Scan
Pulmonary Angiogram
A Pulmonary Angiogram is an invasive procedure involving injecting a contrast medium through a catheter threaded into the pulmonary artery or the right side of the heart to visualize the pulmonary vasculature. Computed Tomography (CT) scans have mainly replaced this...
01:25Imaging Studies II: Positron Emission Tomography and Scintigraphy
Fundamental Principles of PET