18F-FDG uptake during early adjuvant chemotherapy predicts histologic response in pediatric and young adult patients with osteosarcoma

James C. Davis, Najat Daw Bitar, Fariba Navid, Catherine A. Billups, Jianrong Wu, Armita Bahrami, Jesse J. Jenkins, Scott E. Snyder, Wilburn E. Reddick, Victor M. Santana, M. Beth McCarville, Junyu Guo, Barry L. Shulkin

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Abstract

The purpose of this study was to determine the relationship of 18F-FDG uptake in the primary tumor at diagnosis, during therapy, and after therapy with a histologic response and event-free survival in pediatric and young adult patients with osteosarcoma (OS). Methods: Serial (baseline and 5 and 10 wk after start of therapy) 18F-FDG PET/CT imaging was performed in patients with newly diagnosed OS treated uniformly in a therapeutic trial at a single institution. Whole-body images were obtained approximately 1 h after injection of 18F-FDG. Logistic regression was used to study the association of tumor uptake and changes in SUVmax between 0, 5, and 10 wk for both clinical endpoints. Results: Thirty-four patients (17 males; median age, 12.2 y; age range, 6.8–19.1 y) underwent PET imaging; 25 (74%) had localized disease. Primary tumor locations included the femur (n 5 17; 50%), tibia (n 5 9; 26%), and humerus (n 5 5; 15%). Logistic regression showed that SUVmax at 5 wk (P 5 0.034) and 10 wk (P 5 0.022) and percentage change from baseline at 10 wk (P 5 0.021) were highly predictive of a histologic response. Using SUVmax of 4.04 at week 5, SUVmax of 3.15 at week 10, and 60% decrease from baseline at week 10 as cutoff values, we determined that the respective sensitivities were 0.93, 0.93, and 0.79 and that the respective specificities were 0.53, 0.71, and 0.76. Conclusion: SUVmax on routine images at 5 or 10 wk and percentage change in SUVmax from baseline to week 10 were metabolic predictors of a histologic response in OS. These findings may be useful in the early identification of patients who are responding poorly to therapy and may benefit from a change in treatment.

LanguageEnglish (US)
Pages25-30
Number of pages6
JournalJournal of Nuclear Medicine
Volume59
Issue number1
DOIs
StatePublished - Jan 1 2018

Fingerprint

Fluorodeoxyglucose F18
Osteosarcoma
Adjuvant Chemotherapy
Young Adult
Pediatrics
Therapeutics
Logistic Models
Neoplasms
Body Image
Humerus
Tibia
Femur
Disease-Free Survival
Injections

Keywords

  • 18F-FDG
  • Osteosarcoma
  • Pediatrics
  • PET/CT

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

18F-FDG uptake during early adjuvant chemotherapy predicts histologic response in pediatric and young adult patients with osteosarcoma. / Davis, James C.; Daw Bitar, Najat; Navid, Fariba; Billups, Catherine A.; Wu, Jianrong; Bahrami, Armita; Jenkins, Jesse J.; Snyder, Scott E.; Reddick, Wilburn E.; Santana, Victor M.; Beth McCarville, M.; Guo, Junyu; Shulkin, Barry L.

In: Journal of Nuclear Medicine, Vol. 59, No. 1, 01.01.2018, p. 25-30.

Research output: Contribution to journalArticle

Davis, JC, Daw Bitar, N, Navid, F, Billups, CA, Wu, J, Bahrami, A, Jenkins, JJ, Snyder, SE, Reddick, WE, Santana, VM, Beth McCarville, M, Guo, J & Shulkin, BL 2018, '18F-FDG uptake during early adjuvant chemotherapy predicts histologic response in pediatric and young adult patients with osteosarcoma' Journal of Nuclear Medicine, vol. 59, no. 1, pp. 25-30. https://doi.org/10.2967/jnumed.117.190595
Davis, James C. ; Daw Bitar, Najat ; Navid, Fariba ; Billups, Catherine A. ; Wu, Jianrong ; Bahrami, Armita ; Jenkins, Jesse J. ; Snyder, Scott E. ; Reddick, Wilburn E. ; Santana, Victor M. ; Beth McCarville, M. ; Guo, Junyu ; Shulkin, Barry L. / 18F-FDG uptake during early adjuvant chemotherapy predicts histologic response in pediatric and young adult patients with osteosarcoma. In: Journal of Nuclear Medicine. 2018 ; Vol. 59, No. 1. pp. 25-30.
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abstract = "The purpose of this study was to determine the relationship of 18F-FDG uptake in the primary tumor at diagnosis, during therapy, and after therapy with a histologic response and event-free survival in pediatric and young adult patients with osteosarcoma (OS). Methods: Serial (baseline and 5 and 10 wk after start of therapy) 18F-FDG PET/CT imaging was performed in patients with newly diagnosed OS treated uniformly in a therapeutic trial at a single institution. Whole-body images were obtained approximately 1 h after injection of 18F-FDG. Logistic regression was used to study the association of tumor uptake and changes in SUVmax between 0, 5, and 10 wk for both clinical endpoints. Results: Thirty-four patients (17 males; median age, 12.2 y; age range, 6.8–19.1 y) underwent PET imaging; 25 (74{\%}) had localized disease. Primary tumor locations included the femur (n 5 17; 50{\%}), tibia (n 5 9; 26{\%}), and humerus (n 5 5; 15{\%}). Logistic regression showed that SUVmax at 5 wk (P 5 0.034) and 10 wk (P 5 0.022) and percentage change from baseline at 10 wk (P 5 0.021) were highly predictive of a histologic response. Using SUVmax of 4.04 at week 5, SUVmax of 3.15 at week 10, and 60{\%} decrease from baseline at week 10 as cutoff values, we determined that the respective sensitivities were 0.93, 0.93, and 0.79 and that the respective specificities were 0.53, 0.71, and 0.76. Conclusion: SUVmax on routine images at 5 or 10 wk and percentage change in SUVmax from baseline to week 10 were metabolic predictors of a histologic response in OS. These findings may be useful in the early identification of patients who are responding poorly to therapy and may benefit from a change in treatment.",
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AU - Daw Bitar, Najat

AU - Navid, Fariba

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AU - Wu, Jianrong

AU - Bahrami, Armita

AU - Jenkins, Jesse J.

AU - Snyder, Scott E.

AU - Reddick, Wilburn E.

AU - Santana, Victor M.

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