Dynamic contrast-enhanced MR imaging evaluation of osteosarcoma response to neoadjuvant chemotherapy

Authors

  • Wilburn E. Reddick PhD,

    Corresponding author
    1. Departments of Diagnostic Imaging, St. Jude Children's Research Hospital. 332 No Lauderdale. Memphis. TN 38101
    2. Department of Electrical Engineering, University of Memphis. Memphis. TN 38152
    • Departments of Diagnostic Imaging, St. Jude Children's Research Hospital. 332 No Lauderdale. Memphis. TN 38101
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  • Ravi Bhargava MD, FRCPC,

    1. Department of Electrical Engineering, University of Memphis. Memphis. TN 38152
    2. Departments of Diagnostic Imaging, St. Jude Children's Research Hospital. 332 No Lauderdale. Memphis. TN 38101
    3. Departments of Radiology, University of Tennessee. School of Medicine. Memphis. TN
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  • June S. Taylor PhD,

    1. Departments of Diagnostic Imaging, St. Jude Children's Research Hospital. 332 No Lauderdale. Memphis. TN 38101
    2. Departments of Radiology, University of Tennessee. School of Medicine. Memphis. TN
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  • William H. Meyer MD,

    1. Hematology/Oncology, St. Jude Children's Research Hospital. 332 No Lauderdale. Memphis. TN 38101
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  • Barry D. Fletcher MD

    1. Pediatrics, University of Tennessee. School of Medicine. Memphis. TN
    2. Departments of Diagnostic Imaging, School of Medicine. Memphis. TN
    3. Departments of Radiology, University of Tennessee. School of Medicine. Memphis. TN
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Abstract

Assessment of osteosarcoma response to neoadjuvant chemotherapy has prognostic implications, but conventional imaging techniques have been unable to provide an accurate quantitative measure of tumor response. We developed an analysis of dynamic contrast-enhanced MR imaging (DEMRI) to render an image of dynamic vector magnitudes (DVM) and to summarize the result in a quantitative parameter, mean DVM for the lesion (μDVM). We compared the (μDVM from the examination before surgery with histologic results from an en bloc resection of the tumor in 19 cases. The final μDVM value provided an accurate (89.5%) measure of tumor necrosis in osteosarcoma. Further, we analyzed the findings in 17 patients with osteosarcoma who completed three DEMRI examinations during the course of therapy. Tumors with higher μDVM values at presentation had greater decreases in the parameter over the course of therapy. These results are consistent with the distribution of DVM values in these lesions serving as an indicator of tumor perfusion and a possible surrogate variable for drug delivery.

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