Henderson Eric R, Xu Xiaochun, Pogue Brian W, Samkoe Kimberley S, Anderson Megan E
Sarcoma & Connective Tissue Oncology Program & Department of Orthopaedic Surgery, Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.
Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.
Ann Jt. 2020 Oct;5. doi: 10.21037/aoj-20-70. Epub 2020 Oct 15.
Survival following a diagnosis of osteosarcoma is correlated strongly with response to chemotherapy. Mineralization changes seen on radiographs have been hypothesized to correlate with chemotherapy response, however, this has never been analyzed using modern techniques.
Retrospective review of radiographs obtained before and after neoadjuvant chemotherapy was performed for 31 patients with high-grade, conventional osteosarcoma. Pre-chemotherapy (PreC) images and post-chemotherapy (PostC) images were co-registered. Tumor luminance measurements were normalized based on the non-tumor bone and then the relative change in tumor mineralization were measured.
Mean luminance values for pre-chemotherapy non-tumor-affected bone and tumor were 0.63±0.12 and 0.65±0.12, respectively. Mean values for PostC non-tumor-affected bone were 0.59±0.14 and 0.64±0.10, respectively. Once normalized, osteosarcoma mineralization change showed a statistically significant moderate correlation-Pearson correlation coefficient (ρ) of 0.36 (P=0.038)-with the tumor necrosis value.
Moderate, positive correlation was found between osteosarcoma mineralization change during chemotherapy and chemotherapy response. Further work is required to determine if these findings are prognostic by identifying best practice for image analysis and repeating this work with prospectively acquired digital radiographs using uniform technique and phantom normalization.
骨肉瘤诊断后的生存率与化疗反应密切相关。X线片上观察到的矿化变化被认为与化疗反应相关，然而，从未使用现代技术对此进行分析。
对31例高级别、传统型骨肉瘤患者新辅助化疗前后获得的X线片进行回顾性研究。将化疗前（PreC）图像和化疗后（PostC）图像进行配准。基于非肿瘤骨对肿瘤亮度测量值进行归一化，然后测量肿瘤矿化的相对变化。
化疗前非肿瘤受累骨和肿瘤的平均亮度值分别为0.63±0.12和0.65±0.12。化疗后非肿瘤受累骨的平均值分别为0.59±0.14和0.64±0.10。归一化后，骨肉瘤矿化变化与肿瘤坏死值呈统计学显著的中度相关性——Pearson相关系数（ρ）为0.36（P = 0.038）。
化疗期间骨肉瘤矿化变化与化疗反应之间存在中度正相关。需要进一步开展工作，通过确定图像分析的最佳实践，并使用统一技术和体模归一化对前瞻性获取的数字X线片重复此项工作，来确定这些发现是否具有预后价值。
