Eftekhari Farzin
Department of Diagnostic Radiology, Division of Diagnostic Imaging, The University of Texas M.D. Anderson Cancer Center, Houston, TX USA.
Cancer Treat Res. 2009;152:33-62. doi: 10.1007/978-1-4419-0284-9_3.
Osteosarcoma is an aggressive tumor of mesenchymal origin, capable of producing osteoid and immature bone. It is the most frequent primary malignant skeletal neoplasm in children and adolescents. Imaging studies play a major role in initial diagnosis, staging, and assessment of tumor response to chemotherapy. Conventional radiography is the prime imaging modality for diagnosis of bony tumors. Radionuclide bone scan is used in detection of metastatic lesions in the other bones. Computed tomography may be used as an adjunct to conventional radiography, but its main role is detection of pulmonary metastasis. The standard magnetic resonance imaging is the most specific modality for local staging and monitoring response to chemotherapy, and distinguishing postsurgical changes from residual tumor. Dynamic contrast-enhanced magnetic resonance imaging has been introduced to quantify the percentage of tumor necrosis, identify early responders, and thus predict survival. The role of 18F fluorodeoxyglucose positron emission tomography (PET) in the staging and management of osteosarcoma is evolving. It has the advantage of total body imaging and may have an overall role in tumor staging and grading, detection of early response, and therefore, in the prognosis and detection of recurrence.
骨肉瘤是一种起源于间充质的侵袭性肿瘤，能够产生类骨质和不成熟骨。它是儿童和青少年中最常见的原发性恶性骨肿瘤。影像学检查在初始诊断、分期以及评估肿瘤对化疗的反应中起着主要作用。传统X线摄影是诊断骨肿瘤的主要影像学方法。放射性核素骨扫描用于检测其他骨骼中的转移病灶。计算机断层扫描可作为传统X线摄影的辅助手段，但其主要作用是检测肺转移。标准磁共振成像对于局部分期和监测化疗反应以及区分术后改变与残留肿瘤是最具特异性的方法。动态对比增强磁共振成像已被用于量化肿瘤坏死百分比、识别早期反应者，从而预测生存率。18F氟脱氧葡萄糖正电子发射断层扫描（PET）在骨肉瘤分期和治疗中的作用正在不断发展。它具有全身成像的优势，可能在肿瘤分期和分级、早期反应检测以及因此在预后和复发检测中发挥全面作用。
