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Prediction of final tumor response to preoperative chemotherapy by Tc‐99m MIBI imaging at the middle of chemotherapy in malignant bone and soft tissue tumors: Comparison with Tl‐201 imaging
Author(s) -
Taki Junichi,
Higuchi Takahiro,
Sumiya Hisashi,
Tsuchiya Hiroyuki,
Minato Hiroshi,
Tomita Katsuro,
Tonami Norihisa
Publication year - 2008
Publication title -
journal of orthopaedic research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.041
H-Index - 155
eISSN - 1554-527X
pISSN - 0736-0266
DOI - 10.1002/jor.20522
Subject(s) - chemotherapy , medicine , nuclear medicine , scintigraphy , histopathology , soft tissue , perfusion , radiology , lesion , perfusion scanning , pathology
Abstract The aim of this study was to assess the predictive power of 99m Tc‐MIBI scintigraphy performed in the middle of chemotherapy, for the final tumor response to chemotherapy, and compare it to that of 201 Tl in malignant bone and soft tissue tumors (MBST). Sixty‐eight patients with MBST underwent 99m Tc‐MIBI and 201 Tl scintigraphies at 15 min after tracer injection before the first, and after the third, chemotherapy cycles. After five cycles of chemotherapy and tumor resection, therapeutic effect was assessed by histopathology. Less than 90% and ≥90% necrosis were judged as poor and good response to chemotherapy, respectively. Tracers uptake ratios were calculated by dividing the lesion count density by that of the background. 99m Tc‐MIBI perfusion index was also calculated. The % reduction of the perfusion index (ΔPI) and uptake ratios (ΔUR) calculated by 100 × [(prechemotherapy value − postchemotherapy value)/prechemotherapy value] were compared with histologic response. The sensitivity, specificity, and accuracy for the prediction of effective chemotherapy in 99m Tc‐MIBI imaging were 80%, 95%, 88% in ΔUR, and 74%, 74%, 74% in ΔPI, respectively. The area under the receiver operator characteristic curve (A z ) of the 99m Tc‐MIBI‐ΔUR (0.923) was significantly higher than that of ΔPI (0.809, p = 0.025) but only marginally higher than that of the 201 Tl‐ΔUR (0.865, p = 0.079). A z in 201 Tl (0.865) was not significantly different from that of ΔPI (0.809, p = 0.35). 99m Tc‐MIBI imaging performed in the middle of chemotherapy well predicts the final tumor response to chemotherapy in patients with malignant bone and soft tissue tumors. © 2007 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 26:411–418, 2008