FDG-PET/CT Imaging Predicts Histopathologic Treatment Responses after Neoadjuvant Therapy in Adult Primary Bone Sarcomas
Matthias R. Benz,
Johannes Czernin,
William D. Tap,
Jeffrey J. Eckardt,
Leanne L. Seeger,
Martin S. Allen-Auerbach,
Sarah M. Dry,
Michael E. Phelps,
Wolfgang A. Weber,
Fritz C. Eilber
Affiliations
Matthias R. Benz
Ahmanson Biological Imaging Division, Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095-1782, USA
Johannes Czernin
Ahmanson Biological Imaging Division, Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095-1782, USA
William D. Tap
Division of Medical Oncology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095-1782, USA
Jeffrey J. Eckardt
Department of Orthopedic Oncology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095-1782, USA
Leanne L. Seeger
Department of Radiology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095-1782, USA
Martin S. Allen-Auerbach
Ahmanson Biological Imaging Division, Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095-1782, USA
Sarah M. Dry
Department of Pathology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095-1782, USA
Michael E. Phelps
Ahmanson Biological Imaging Division, Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095-1782, USA
Wolfgang A. Weber
Abteilung Nuklearmedizin, University of Freiburg, 79106 Freiburg, Germany
Fritz C. Eilber
Ahmanson Biological Imaging Division, Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095-1782, USA
Purpose. The aim of this study was to prospectively evaluate whether FDG-PET allows an accurate assessment of histopathologic response to neoadjuvant treatment in adult patients with primary bone sarcomas. Methods. Twelve consecutive patients with resectable, primary high grade bone sarcomas were enrolled prospectively. FDG-PET/CT imaging was performed prior to the initiation and after completion of neoadjuvant treatment. Imaging findings were correlated with histopathologic response. Results. Histopathologic responders showed significantly more pronounced decreases in tumor FDG-SUVmax from baseline to late follow up than non-responders (64±19% versus 29±30 %, resp.; P=.03). Using a 60% decrease in tumor FDG-uptake as a threshold for metabolic response correctly classified 3 of 4 histopathologic responders and 7 of 8 histopathologic non-responders as metabolic responders and non-responders, respectively (sensitivity, 75%; specificity, 88%). Conclusion. These results suggest that changes in FDG-SUVmax at the end of neoadjuvant treatment can identify histopathologic responders and non-responders in adult primary bone sarcoma patients.
