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Thallium-201 scintigraphy to assess effect of chemotherapy in osteosarcoma
K Ohtomo1, S Terui, R Yokoyama
1Division of Nuclear Medicine, National Cancer Center Hospital, Tokyo, Japan.
Unlabelled:
Imaging results in patients with high-grade osteosarcoma of the extremities were reviewed to determine whether scintigraphic appearance correlated with histologic response to preoperative chemotherapy.
Methods:
Histologically, the percent tumor necrosis in specimens from 30 patients were classified into three grades: grade 1 = necrosis less than 60%, grade 2 = 60%-89% necrosis and grade 3 = diffuse necrosis greater than 90% based upon whole transverse sections. Scintigraphically, we analyzed 201TI uptake before and after preoperative chemotherapy. The changes in the tumor-to-background ratio were defined by an alteration ratio.
Results:
Of the 11 patients with a grade 1 response, the ratio showed -67.1% +/- 45.4% (mean +/- s.d.). Of the 9 patients with a grade 2 response, the ratio showed 37.9% +/- 29.9% of the 10 patients with a grade 3 response the ratio showed 105.5% +/- 12.4%. The ratios correlated well with the histologic grades (p < 0.0001; analysis of variance).
Conclusion:
Thallium-201 scintigraphy accurately assesses the effect of chemotherapy on osteosarcoma.