Initial Metabolic Tumor Volume Measured by 18F-FDG PET/CT Can Predict the Outcome of Osteosarcoma of the Extremities

Journal of Nuclear Medicine

Byung Hyun Byun¹  Wan Hyeong Cho¹  Chang-Bae Kong¹  Sang Moo Lim¹  Jae-Soo Koh¹  Dae-Geun Jeon¹  Youngseok Seo¹  Soo-Yong Lee¹  Ilhan Lim¹  Jihyun Park¹  Chang Woon Choi¹ 

关键词: ¹⁸F-FDG;    PET/CT;    metabolic tumor volume;    osteosarcoma;    survival;   

DOI  :  10.2967/jnumed.112.117697

学科分类：医学（综合）

来源: Society of Nuclear Medicine

【 摘 要 】

We evaluated the ability of metabolic and volumetric parameters measured by pretreatment 18F-FDG PET/CT to predict the survival of patients with osteosarcoma of the extremities. Methods: The records of 83 patients with American Joint Committee on Cancer stage II extremity osteosarcoma treated with surgery and chemotherapy were retrospectively reviewed. Imaging parameters (maximum standardized uptake value, metabolic tumor volume [MTV], total lesion glycolysis, and tumor volume based on MR images) were measured before treatment, and histologic responses to neoadjuvant chemotherapy were assessed by examination of postsurgical specimens. Receiver-operating-characteristic curve analyses and the Cox proportional hazards model were used to analyze whether imaging and clinicopathologic parameters could predict metastasis-free survival. Results: Of the imaging parameters, MTV at the fixed standardized uptake value threshold of 2.0 (MTV(2.0)) most accurately predicted metastasis by receiver-operating-characteristic curve analysis (area under the curve = 0.679, P = 0.011). By multivariate analysis, MTV(2.0) > 105 mL (relative risk, 3.93; 95% confidence interval, 1.55–9.92) and poor response to neoadjuvant chemotherapy (relative risk, 4.83; 95% confidence interval, 1.64–14.21) independently shortened metastasis-free survival (P = 0.004 for both parameters). The stratification of patients by the combined criteria of MTV(2.0) and histologic response predicted outcome in more detail. Conclusion: MTV is an independent predictor of metastasis in patients with osteosarcoma of the extremities. The combination of MTV and histologic response predicts survival more accurately than the chemotherapeutic response alone.

【 授权许可】

Unknown