Quantitative ^99mTc-MDP SPECT/CT for predicting neoadjuvant chemotherapy efficacy in osteosarcoma

Area of Science:

• Oncology
• Nuclear Medicine
• Radiology

Background:

• Osteosarcoma (OS) is a common primary malignant bone tumor.
• Limited research exists on predicting neoadjuvant chemotherapy (NACT) efficacy using quantitative 99mTechnetium-methylene diphosphonate single photon emission computed tomography/computed tomography (99mTc-MDP SPECT/CT).

Purpose of the Study:

• To evaluate the predictive value of quantitative 99mTc-MDP SPECT/CT for NACT efficacy in OS patients.

Main Methods:

• Retrospective analysis of 67 OS patients' 99mTc-MDP bone scans and quantitative 99mTc-MDP SPECT/CT data.
• NACT efficacy assessed via postoperative pathology.
• Evaluated maximum tumor/nontumor radioactive count (T/NTmax) and maximum standardized uptake value (SUVmax) pre- and post-NACT, including percentage changes (ΔT/NTmax, ΔSUVmax).

Main Results:

• Post-NACT SUVmax was significantly lower in the good efficacy group (19.1) compared to the poor efficacy group (34.9) (P=0.006).
• The good efficacy group exhibited greater reductions in ΔT/NTmax (-20.2%) and ΔSUVmax (-32.5%) versus the poor efficacy group (24.3% and 21.0%, respectively).
• ΔSUVmax demonstrated a higher area under the curve (0.811) than ΔT/NTmax (0.712) (P=0.021), indicating superior predictive value.

Conclusions:

• Quantitative 99mTc-MDP SPECT/CT is an effective tool for predicting NACT efficacy in osteosarcoma.
• ΔSUVmax derived from quantitative 99mTc-MDP SPECT/CT offers significant predictive value for NACT response in OS.