一种评估原发性骨肉瘤化疗反应的新型联合放射学方法。

A novel combined radiological method for evaluation of the response to chemotherapy for primary bone sarcoma.

机构信息

Department of Orthopaedic Surgery, Kanazawa University School of Medicine, Kanazawa, Japan.

出版信息

J Surg Oncol. 2012 Sep 1;106(3):273-9. doi: 10.1002/jso.23074. Epub 2012 Mar 2.

DOI:10.1002/jso.23074

PMID:22389049

Abstract

BACKGROUND

In the treatment of bone sarcoma, evaluation of chemotherapeutic effects is extremely important. In this study, we compared radiological evaluations and histological response, and developed a combined radiological scoring system for assessing the response to chemotherapy.

METHODS

A total of 79 patients with primary bone sarcomas were examined by X-ray photography (Xp), angiography, MRI, 201Tl scintigraphy (Tl) and 99mTc-MIBI scintigraphy (MIBI) to evaluate their response to preoperative chemotherapy. Patients were classified as responders and non-responders according to radiological images. All resected tumors were evaluated histologically and classified as a good response (≥90% necrosis) or a poor response (≤90% necrosis). The sensitivity, specificity, accuracy, and kappa values in radiological evaluation were calculated. Furthermore, we developed a combined radiological scoring system that correlated the results of radiological images with histological response.

RESULTS

Sensitivity, specificity, and accuracy were 90.9%, 38.2%, and 67.5% (K = 0.31), respectively, for Xp; 91.7%, 33.3%, and 66.7% (K = 0.27) for angiography; 81.0%, 67.6%, and 75.0% (K = 0.49) for MRI; 78.9%, 72.4%, and 76.1% (K = 0.51) for Tl; 85.3%, 69.2%, and 78.3% (K = 0.55) for MIBI; and 93.3%, 76.5%, and 86.1% (K = 0.71) for combined radiological scoring.

CONCLUSIONS

Combined radiological evaluations showed high correlation with histological response for assessing the effects of chemotherapy.

摘要

背景

在骨肉瘤的治疗中，评估化疗效果至关重要。本研究比较了影像学评估和组织学反应，并建立了一种联合影像学评分系统，用于评估化疗反应。

方法

对 79 例原发性骨肉瘤患者进行 X 线摄影（Xp）、血管造影、MRI、201Tl 闪烁扫描（Tl）和 99mTc-MIBI 闪烁扫描（MIBI）检查，以评估其术前化疗反应。根据影像学图像将患者分为反应者和非反应者。所有切除的肿瘤均进行组织学评估，并分为良好反应（≥90%坏死）或不良反应（≤90%坏死）。计算影像学评估的敏感性、特异性、准确性和 Kappa 值。此外，我们建立了一种联合影像学评分系统，将影像学结果与组织学反应相关联。

结果

Xp 的敏感性、特异性和准确性分别为 90.9%、38.2%和 67.5%（K=0.31）；血管造影的敏感性、特异性和准确性分别为 91.7%、33.3%和 66.7%（K=0.27）；MRI 的敏感性、特异性和准确性分别为 81.0%、67.6%和 75.0%（K=0.49）；Tl 的敏感性、特异性和准确性分别为 78.9%、72.4%和 76.1%（K=0.51）；MIBI 的敏感性、特异性和准确性分别为 85.3%、69.2%和 78.3%（K=0.55）；联合影像学评分的敏感性、特异性和准确性分别为 93.3%、76.5%和 86.1%（K=0.71）。