OBJECTIVE: Ewing sarcoma (ES) and osteosarcoma (OS) have different biological characteristics and respond differently to chemotherapy. We reviewed (18)F-FDG PET imaging characteristics of ES and OS patients at baseline and following treatment to determine whether this biological variation is reflected in their imaging phenotype. MATERIALS AND METHODS: A retrospective review of ES and OS patients treated with neoadjuvant chemotherapy and surgery was done, correlating PET results with histologic response to chemotherapy. RESULTS: Change in the maximum standardized uptake value (SUVmax) between baseline and post-treatment scanning was not significantly associated with histologic response for either ES or OS. Metabolic tumor volume (MTV) and the percentage of injected (18)F-FDG dose (%ID) in the primary tumor were found to be different for ES and OS response subgroups. A 50% reduction in MTV (MTV2:1 < 0.5) was found to be significantly associated with favorable histologic response in OS. Using the same criteria for ES incorrectly predicted good responders. Increasing the cut-off values for ES to a 90% reduction in MTV (MTV2:1 < 0.1) resulted in association with favorable histologic response. CONCLUSION: Response to neoadjuvant chemotherapy as reflected by changes in PET characteristics should be interpreted differently for ES and OS.
OBJECTIVE:Ewing sarcoma (ES) and osteosarcoma (OS) have different biological characteristics and respond differently to chemotherapy. We reviewed (18)F-FDG PET imaging characteristics of ES and OS patients at baseline and following treatment to determine whether this biological variation is reflected in their imaging phenotype. MATERIALS AND METHODS: A retrospective review of ES and OS patients treated with neoadjuvant chemotherapy and surgery was done, correlating PET results with histologic response to chemotherapy. RESULTS: Change in the maximum standardized uptake value (SUVmax) between baseline and post-treatment scanning was not significantly associated with histologic response for either ES or OS. Metabolic tumor volume (MTV) and the percentage of injected (18)F-FDG dose (%ID) in the primary tumor were found to be different for ES and OS response subgroups. A 50% reduction in MTV (MTV2:1 < 0.5) was found to be significantly associated with favorable histologic response in OS. Using the same criteria for ES incorrectly predicted good responders. Increasing the cut-off values for ES to a 90% reduction in MTV (MTV2:1 < 0.1) resulted in association with favorable histologic response. CONCLUSION: Response to neoadjuvant chemotherapy as reflected by changes in PET characteristics should be interpreted differently for ES and OS.
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