18F-sodium fluoride positron emission tomography (NaF-18-PET/CT) radiomic signatures to evaluate responses to alpha-particle Radium-223 dichloride therapy in osteosarcoma metastases

Kalevi Kairemo, Jason Roszik, Pete Anderson, Gregory Ravizzini, Arvind Rao, Homer A. Macapinlac, Vivek Subbiah

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Patients with osteoblastic metastases from high risk osteosarcoma continue to have a poor prognosis after progression from standard-of-care multi-agent chemotherapy. In a first-in-human dose escalation trial of bone targeted Radium 223 dichloride alpha-particle therapy in 18 patients with advanced osteosarcoma only 1 patient responded based on conventional Response Evaluation Criteria in Solid Tumors (RECIST). Na18F PET response Criteria in Solid Tumors(NAFCIST), based on Sodium fluoride-18 (Na18F) positron emission tomography (PET)-CT was developed to better evaluate bone specific response. To further appreciate the spatial and temporal heterogeneity of the partial or mixed responses, a radiomics method was developed. Analyses were performed with 18F-sodium fluoride positron emission tomography imaging studies before and after alpha-particle therapy. Radioactive 18F -atom concentrations were measured in soft-tissues, in approximately 1000 concentration data points for 18F per 1 cm3 metastatic tumor. Data was analyzed from the SUV intensity values, the histogram of intensities and entropy values. Radiomics may inform intra-tumoral and inter-tumoral heterogeneity in response of bone forming osteosarcoma to alpha particle therapy. Each patient (and each tumor) represents an “N of 1” case and warrants in depth analysis individually.

Original languageEnglish (US)
Article number100797
JournalCurrent Problems in Cancer
Volume45
Issue number5
DOIs
StatePublished - Oct 2021

Keywords

  • Alpha therapy
  • Entropy
  • Fluorine-18 isotopes
  • Osteosarcoma
  • Positron emission tomography
  • Radiomics
  • Radium-223 isotopes
  • Sodium fluoride PET

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

MD Anderson CCSG core facilities

  • Bioinformatics Shared Resource

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