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Response Monitoring to Neoadjuvant Chemotherapy in Osteosarcoma Using Dynamic Contrast-Enhanced MR Imaging

  • Imaging
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Abstract

To evaluate the dynamic contrast-enhanced MRI parameters for monitoring the neoadjuvant chemotherapy (NAC) response in osteosarcoma prospectively. A total of 19 patients with osteosarcoma were recruited and underwent two dynamic contrast-enhanced MRI (DCE-MRI) examinations before and after chemotherapy. Patients with ≥ 90% tumor necrosis were defined as responders (10 patients), and those < 90% necrosis were defined as non-responders (9 patients). Primary tumor kinetic parameters of DCE were measured including Ktrans, Kep, Ve, and Vp with the extended Tofts model. The change in tumor volume was also recorded in the treatment cycle. The changes between responders and non-responders were compared using t test or Mann–Whitney U test. The ROC curves were used to evaluate the ability of DCE parameters for differentiating the responders and non-responders with respect to chemotherapy. Statistically significant differences were not detected in Ktrans, Kep, Vp, Ve, and MRV between responder and non-responder groups before chemotherapy. The Ktrans and Kep showed significant differences between responder and non-responder groups after completion of NAC (P < 0.05). Compared to the non-responders, the Ktrans and Kep were significantly lower in the responders than non-responders after completion of NAC (P < 0.05). The sensitivity, specificity, and diagnostic accuracy of Ktrans (Ktrans-post) and Kep (Kep-post) were distinguished between the non-responder and responder groups. Ktrans (Ktrans-post) and Kep (Kep-post) were analyzed together to differentiate between responders and non-responders that revealed the largest AUCs. The current study showed that the DCE parameters could adequately monitor the response to NAC in the osteosarcoma treatment cycle.

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Abbreviations

DCE-MRI:

Dynamic contrast-enhanced magnetic resonance imaging

NAC:

Neoadjuvant chemotherapy

MRV:

Tumor volume based on magnetic resonance images

Ktrans:

Perfusion maps of the volume transfer constant

Kep:

Reverse volume transfer constant

Ve:

Extravascular extracellular volume fraction

Vp:

Blood volume fraction

CRT:

Chemoradiation

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Authors and Affiliations

  1. Department of Radiology, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China

    Bu-Tian Zhang, Qian Zheng, Lin Liu, Yi-Meng Dai & Kai-ming Xue

  2. Department of Radiology, Huadu district Peoples’ Hospital, Guangzhou, Guangdong, China

    Yan-Ni Zeng

  3. Department of Science research, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China

    Jin-Lan Jiang

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  1. Bu-Tian Zhang
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  2. Qian Zheng
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  3. Lin Liu
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  5. Yi-Meng Dai
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  6. Jin-Lan Jiang
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Correspondence to Bu-Tian Zhang.

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The authors declare that they have no conflict of interest.

Ethical Approval

The study was approved by the institutional research review board and performed according to the ethical guidelines of the clinical research committee of China–Japan Hospital of Jilin University.

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All patients provided written informed consent.

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This article is part of the Topical Collection on Imaging

Key points

·Dynamic contrast-enhanced MR imaging (DCE-MRI) provides functional information on tumor vascularity and hemodynamics.

·Some DCE-MRI parameters have a good performance in differentiating responders from non-responders osteosarcoma during neoadjuvant chemotherapy.

·Kinetic parameters of DCE-MRI might be potentially optimal noninvasive radiological prognostic indicators for osteosarcoma.

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Zhang, BT., Zheng, Q., Liu, L. et al. Response Monitoring to Neoadjuvant Chemotherapy in Osteosarcoma Using Dynamic Contrast-Enhanced MR Imaging. SN Compr. Clin. Med. 1, 319–327 (2019). https://doi.org/10.1007/s42399-019-00059-4

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