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Colour Doppler ultrasound predicts chemotherapy response, but not survival in paediatric osteosarcoma

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Abstract

Background: Histological response to chemotherapy is an important prognostic factor in osteosarcoma, influencing therapeutic considerations. It would be advantageous to be able to assess chemotherapy response, and predict survival, prior to tumour resection. Colour Doppler US (CDUS) is non-invasive, non-demanding for the patient, and easy to plan. This makes the method especially suitable for children, who comprise the majority of patients. Objective: To establish the value of CDUS for pre-operative prediction of chemotherapy response and survival, using widely available US equipment. Materials and methods: CDUS was performed in 21 consecutive patients before and after chemotherapy. Peak systolic velocity (PSV) in the soft-tissue component of the tumour and quotient of resistive index (QRI) of the feeding artery and contralateral control were calculated. A pathologist, unaware of CDUS results, assessed the response to chemotherapy after resection. Results: QRI change after chemotherapy was significantly higher in histological responders. No correlation of QRI change with survival was found. There was no significant difference in PSV change comparing any subgroup. CDUS appeared useful in predicting chemotherapy response (sensitivity 83%, specificity 86%), especially for negative response (predictive value 92%). Survival could not be predicted accurately. Conclusions: CDUS can predict chemotherapy response, but not survival. The method could be useful in planning treatment prior to definitive surgery.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Academic Medical Centre, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands

    Jos A. M. Bramer, Jan W. van der Eijken & Gerard R. Schaap

  2. Department of Radiology, Spaarne Ziekenhuis, Heemstede, The Netherlands

    Feikje M. Gubler

  3. Department of Radiology, Academic Medical Centre, Amsterdam, The Netherlands

    Mario Maas

  4. Department of Pathology, Academic Medical Centre, Amsterdam, The Netherlands

    Hans Bras

  5. Department of Paediatric Oncology, Academic Medical Centre, Amsterdam, The Netherlands

    Jan de Kraker

Authors
  1. Jos A. M. Bramer
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  2. Feikje M. Gubler
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  3. Mario Maas
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  4. Hans Bras
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  5. Jan de Kraker
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  6. Jan W. van der Eijken
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  7. Gerard R. Schaap
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Correspondence to Jos A. M. Bramer.

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Bramer, J.A.M., Gubler, F.M., Maas, M. et al. Colour Doppler ultrasound predicts chemotherapy response, but not survival in paediatric osteosarcoma. Pediatr Radiol 34, 614–619 (2004). https://doi.org/10.1007/s00247-004-1210-z

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  • DOI: https://doi.org/10.1007/s00247-004-1210-z

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