Department of Nuclear Medicine, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; Department of Nuclear Medicine, Docrates Cancer Center, Helsinki, Finland.
Department of Genomic Medicine, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; Department of Melanoma Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Curr Probl Cancer. 2021 Oct;45(5):100797. doi: 10.1016/j.currproblcancer.2021.100797. Epub 2021 Oct 3.
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). NaF PET response Criteria in Solid Tumors(NAFCIST), based on Sodium fluoride-18 (NaF) 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 F-sodium fluoride positron emission tomography imaging studies before and after alpha-particle therapy. Radioactive F -atom concentrations were measured in soft-tissues, in approximately 1000 concentration data points for F per 1 cm 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.
对于高危骨肉瘤发生成骨转移的患者，在标准多药化疗进展后，预后仍然较差。在 18 例晚期骨肉瘤患者中进行的靶向骨放射性镭 223 二氯化物α粒子治疗的首次人体剂量递增试验中，仅根据实体瘤反应评估标准（RECIST），有 1 例患者有应答。基于氟[18F]正电子发射断层扫描（PET）/CT 的氟[18F]正电子发射断层扫描（PET）-CT 实体瘤氟正电子发射断层扫描（NAFCIST）响应标准，旨在更好地评估骨特异性反应。为了进一步了解部分或混合反应的空间和时间异质性，开发了一种放射组学方法。在α粒子治疗前后，使用 F-氟[18F]正电子发射断层扫描成像研究进行分析。软组织中放射性 F-原子浓度在每个 1cm 转移性肿瘤中约 1000 个 F 浓度数据点进行测量。对 SUV 强度值、强度直方图和熵值进行数据分析。放射组学可能为成骨性骨肉瘤对α粒子治疗的反应提供肿瘤内和肿瘤间异质性的信息。每位患者（和每个肿瘤）都代表一个“N of 1”病例，需要单独进行深入分析。
