Clin Nucl Med 2000 Nov;25(11):874-81
Evaluation of chemotherapy response in primary bone tumors with F-18 FDG
positron emission tomography compared with histologically assessed tumor
necrosis.
Franzius C, Sciuk J, Brinkschmidt C, Jurgens H, Schober O.
PURPOSE: The purpose of this study was to evaluate the potential of positron
emission tomography using F-18-fluoro-2-deoxy-D-glucose (FDG PET) to assess the
chemotherapy response of primary osseous tumors compared with the degree of
necrosis determined histologically. PATIENTS AND METHODS: Seventeen patients
with primary bone tumors (11 osteosarcomas, 6 Ewing's sarcomas) were examined
using FDG PET and planar bone scintigraphy before neoadjuvant chemotherapy and
before surgery. Tumor response was classified histologically according to
Salzer-Kuntschik (grades I-II: good response; grades IV-VI: poor response). In
both imaging methods, quantification was performed using tumor to nontumor
ratios (T:NT). RESULTS: Histologically, 15 patients were classified as having
good responses (grade I, n = 1; grade II, n = 6; grade III, n = 8) and two as
having poor responses (grades IV and V). FDG PET showed more than a 30% decrease
in T:NT ratios in all patients who had good responses. However, three of these
patients had increasing bone scintigraphy T:NT ratios, and another five had
decreasing ratios of less than 30%. The patients with poor responses had
increasing T:NT ratios and decreasing ratios of less than 30%, respectively,
using both imaging methods. CONCLUSIONS: FDG PET seems to be a promising tool
for evaluating the response of primary osseous tumors to chemotherapy. In this
preliminary study, FDG PET was superior to planar bone scintigraphy.
