ABSTRACT
PURPOSE: The current study was designed to evaluate the ability of thallium-201 scintigraphy to predict the response to preoperative chemotherapy in osteosarcoma, by comparing changes in thallium uptake ratio after chemotherapy to the tumor necrosis ratio. MATERIALS AND METHODS: Twelve osteosarcoma patients were included in this study. Thallium-201 scintigraphy was performed before and after preoperative chemotherapy, and the degree of tumor necrosis was estimated by histologic mapping postoperatively. To quantitatively determine thallium uptake, we drew a region of interest on the tumor side and on the contralateral normal side as a mirror image, and calculated the uptake ratio with dividing the gamma count in the tumor side by that of the normal side. We calculated these percent changes of thallium uptake ratio in the early and delayed phases, and compared these to the corresponding tumor necrosis ratio. RESULTS: Percent changes in the thallium uptake ratio were found to be correlated with the tumor necrosis ratio (p<0.03). This correlation was found in both the early (p<0.03) and delayed phase (p<0.03); moreover the correlation coefficient in early phase (0.79) was greater than that in the delayed phase (0.67). CONCLUSION: Thallium-201 scintigraphy could be effective at predicting the response to preoperative chemotherapy in osteosarcoma.
Subject(s)
Humans , Drug Therapy , Necrosis , Osteosarcoma , Radionuclide Imaging , ThalliumABSTRACT
Thallium-201 scintigraphy is used to discriminate the malignant bone tumor from the benign by qualitatively and quantitatively, and to predict the response of preoperative chemotherapy in osteosarcoma, by comparing the changes of thallium uptake ratio after chemotherapy to the tumor necrosis ratio. Thallium-201 scintigraphy scan should be done prior to surgical biopsy. PICKER Prism 2000 gamma camera with high resolution parallel hole collimator is usually used for scanning. The patient is injected with 2-3mCi of Tl-201 and the early phase is checked in 30 minutes and delayed phase in 3 hours. The scan images are visually evaluated by a blinded nuclear medicine physician. We could evaluate true positive, true negative, false positive and false negative by the comparison of results with those of biopsy, and calculate positive and negative predictive value(%), sensitivity(%), specificity(%) and diagnostic accuracy(%). For the quantitative analysis of thallium uptake, we drew the region of interest on the tumor side and contralateral normal side as mirror image, and calculated the uptake ratio with dividing the amount of gamma count in tumor side by normal side. We could calculate the percent changes of thallium uptake ratio in early and delayed phase, and compare them to the ratio of tumor necrosis. Thallium-201 scintigraphy proved as useful imaging study to discriminate malignant bone tumor from benign, but had exception in giant cell tumor and low grade malignant bone tumors. We can use T1-201 scan to differentiate the benign from the malignant tumor, and to evaluate the response of preoperative chemotherapy or radiotherapy, and to determine the residual tumor or local recurrence. For the better result, we need to have a more detail information about false positive cases and a more objective and quantitative reading technique.
Subject(s)
Humans , Biopsy , Drug Therapy , Gamma Cameras , Giant Cell Tumors , Necrosis , Neoplasm, Residual , Nuclear Medicine , Osteosarcoma , Radionuclide Imaging , Radiotherapy , Recurrence , ThalliumABSTRACT
Thallium-201 scintigraphy is used to discriminate the malignant bone tumor from the benign by qualitatively and quantitatively, and to predict the response of preoperative chemotherapy in osteosarcoma, by comparing the changes of thallium uptake ratio after chemotherapy to the tumor necrosis ratio. Thallium-201 scintigraphy scan should be done prior to surgical biopsy. PICKER Prism 2000 gamma camera with high resolution parallel hole collimator is usually used for scanning. The patient is injected with 2-3mCi of Tl-201 and the early phase is checked in 30 minutes and delayed phase in 3 hours. The scan images are visually evaluated by a blinded nuclear medicine physician. We could evaluate true positive, true negative, false positive and false negative by the comparison of results with those of biopsy, and calculate positive and negative predictive value(%), sensitivity(%), specificity(%) and diagnostic accuracy(%). For the quantitative analysis of thallium uptake, we drew the region of interest on the tumor side and contralateral normal side as mirror image, and calculated the uptake ratio with dividing the amount of gamma count in tumor side by normal side. We could calculate the percent changes of thallium uptake ratio in early and delayed phase, and compare them to the ratio of tumor necrosis. Thallium-201 scintigraphy proved as useful imaging study to discriminate malignant bone tumor from benign, but had exception in giant cell tumor and low grade malignant bone tumors. We can use T1-201 scan to differentiate the benign from the malignant tumor, and to evaluate the response of preoperative chemotherapy or radiotherapy, and to determine the residual tumor or local recurrence. For the better result, we need to have a more detail information about false positive cases and a more objective and quantitative reading technique.