Advertisement

Imaging Assessment of Osteosarcoma in Childhood and Adolescence: Diagnosis, Staging, and Evaluating Response to Chemotherapy

  • Farzin Eftekhari
Chapter
Part of the Cancer Treatment and Research book series (CTAR, volume 152)

Abstract

Osteosarcoma is an aggressive tumor of mesenchymal origin, capable of producing osteoid and immature bone. It is the most frequent primary malignant skeletal neoplasm in children and adolescents. Imaging studies play a major role in initial diagnosis, staging, and assessment of tumor response to chemotherapy. Conventional radiography is the prime imaging modality for diagnosis of bony tumors. Radionuclide bone scan is used in detection of metastatic lesions in the other bones. Computed tomography may be used as an adjunct to conventional radiography, but its main role is detection of pulmonary metastasis. The standard magnetic resonance imaging is the most specific modality for local staging and monitoring response to chemotherapy, and distinguishing postsurgical changes from residual tumor. Dynamic contrast-enhanced magnetic resonance imaging has been introduced to quantify the percentage of tumor necrosis, identify early responders, and thus predict survival. The role of 18F fluorodeoxyglucose positron emission tomography (PET) in the staging and management of osteosarcoma is evolving. It has the advantage of total body imaging and may have an overall role in tumor staging and grading, detection of early response, and therefore, in the prognosis and detection of recurrence.

Keywords

Positron Emission Tomography Conventional Radiography Aneurysmal Bone Cyst Local Staging Myositis Ossificans 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgments

The author wishes to thank Dr. Norman Jaffe for his continued support, Drs. Haesun Choi and Leonardo Marcal for sharing their research on DCE-MRI, Kristi Speights for editorial assistance, Mary Carr for secretarial assistance, and Juan Loya for assistance in illustration assistance.

References

  1. 1.
    Mira JM. Osseous tumors of intramedullary origin. In: Mira JM, ed. Bone Tumors: Clinical, Radiologic, and Pathologic Correlations. Philadelphia, Pa: Lea & Febriger; 1989:248-438.Google Scholar
  2. 2.
    Resnick D, Kyriakos M, Greenway GD. Tumor-like diseases of bone: imaging and pathology of specific lesions. In: Resnick D, ed. Diagnosis of Bone and Joint Disorders. 3rd ed. Philadelphia: Saunders; 1995:3662-3697.Google Scholar
  3. 3.
    Huvos AG. Osteogenic sarcoma. Bone Tumors: Diagnosis, Treatment, and Prognosis. Philadelphia, Pa: Saunders; 1991:85-156.Google Scholar
  4. 4.
    Dahlin DC, Coventy MB. Osteogenic sarcoma. A study of six hundred cases. J Bone Joint Surg [Am]. 1967;49:101-110.Google Scholar
  5. 5.
    Jaffe N, Spears R, Eftekhari F, et al. Pathologic Fracture in Osteosarcoma: Impact of chemotherapy on primary tumor and survival. Cancer. 1987;59:701-709.CrossRefPubMedGoogle Scholar
  6. 6.
    Hopper KD, Moser RP, Haseman DB, et al. Osteosarcomatosis. Radiology. 1990;175:233-239.PubMedGoogle Scholar
  7. 7.
    Weatherby RP, Dahlin DC, Ivins JC. Postradiation sarcoma of bone: review of 78 Mayo Clinic cases. Mayo Clin Proc. 1981;56:294-306.PubMedGoogle Scholar
  8. 8.
    Lorigan JG, Libshitz HI, Peuchot M. Radiation-induced sarcoma of the bone: CT findings in 19 cases. AJR. 1989;153:791-794.PubMedGoogle Scholar
  9. 9.
    Kawai A, Sugihara S, Kunisada T, et al. Imaging assessment of the response of bone tumors to preoperative chemotherapy. Clin Orthop Relat Res. 1997;337:216-225.CrossRefPubMedGoogle Scholar
  10. 10.
    Kunisada T, Ozaki T, Kawai A. Imaging assessment of the responses of osteosarcoma patients to preoperative chemotherapy: angiography compared with thallium-201 scintigraphy. Cancer. 1999;86(6):949-956.CrossRefPubMedGoogle Scholar
  11. 11.
    Carrasco CH, Charnsangavej C, Raymond AK, et al. Osteosarcoma: angiographic assessment of response to preoperative chemotherapy. Radiology. 1989;170:839-842.PubMedGoogle Scholar
  12. 12.
    Lang P, Vahlensieck M, Matthay KK. Monitoring neovascularity as an indicator to response to chemotherapy in osteogenic and Ewing sarcoma using magnetic resonance angiography. Med Pediatr Oncol. 1996;26(5):329-333.CrossRefPubMedGoogle Scholar
  13. 13.
    Chung VP, Benjamin R, Jaffe N, et al. Radiographic and angiographic changes in oseosarcoma after intraarterial chemotherapy. AJR. 1982;139:1065-1069.Google Scholar
  14. 14.
    Kumpan W, Lechner G, Wittich GR. The angiographic response of osteosarcoma following pre-operative chemotherapy. Skeletal Radiol. 1986;15(2):96-102.CrossRefPubMedGoogle Scholar
  15. 15.
    Wilkins RM, Cullen JW, Odom L. Superior survival in treatment of primary nonmetastatic pediatric osteosarcoma of the extremity. Ann Surg Oncol. 2003;10(5):481-483.CrossRefGoogle Scholar
  16. 16.
    Van der Woude HJ, Bloem JL, van Oostayen JA, et al. Treatment of high-grade bone sarcomas with neoadjuvant chemotherapy. The utility of sequential color Doppler sonography in predicting histopathologic response. AJR. 1995;165:125-133.PubMedGoogle Scholar
  17. 17.
    Abudu A, Davies AM, Pysent PB, et al. Tumour volume as a predictor of necrosis after chemotherapy in Ewing’s sarcoma. J Bone Joint Surg Br. 1999;81:317-322.CrossRefPubMedGoogle Scholar
  18. 18.
    Holscher HC, Bloem JL, Vanel D, et al. Osteosarcoma: chemotherapy-induced changes at MR imaging. Radiology. 1992;182:839-844.PubMedGoogle Scholar
  19. 19.
    Pan G, Raymond AK, Carrasco CH, et al. Osteosarcoma: MR imaging after preoperative chemotherapy. Radiology. 1990;174:517-526.PubMedGoogle Scholar
  20. 20.
    Marcal L, Choi H, Jackson E, et al. Use of Quantitative Dynamic Contrast MR Imaging to Monitor Musculoskeletal Sarcomas: Correlation with FDG PET and Pathology. E-poster. International Society for Magnetic Resonance in Medicine (ISMRM), Kyoto, Japan. 2004, May 15–21.Google Scholar
  21. 21.
    De Baere T, Vanel D, Shapeero LG, et al. Osteosarcoma after chemotherapy: evaluation with contrast material-enhanced subtraction MR imaging. Radiology. 1992;185:587-592.PubMedGoogle Scholar
  22. 22.
    Shapeero LG, Vanel D. Imaging evaluation of the response of high-grade osteosarcoma and Ewing sarcoma to chemotherapy with emphasis on dynamic contrast-enhanced magnetic resonance imaging. Semin Musculoskelet Radiol. 2000;4:137-146.CrossRefPubMedGoogle Scholar
  23. 23.
    Vanel D, Verstraete KL, Shapeero LG. Primary tumors of the musculoskeletal system. Radiol Clin North Am. 1997;35:213-237.PubMedGoogle Scholar
  24. 24.
    Wunder JS, Paulian G, Huvos AG, et al. The histological response to chemotherapy as a predictor of the oncological outcome of operative treatment of Ewing sarcoma. J Bone Joint Surg Am. 1998;80:1020-1033.CrossRefPubMedGoogle Scholar
  25. 25.
    Shankar LK, Hoffman JM, Bacharach S, et al. Consensus recommendations for the use of 18F-FDG PET as an indicator of therapeutic response in patients in National Cancer Institute trials. J Nucl Med. 2006;47:1059-1066.PubMedGoogle Scholar
  26. 26.
    Brenner W, Bohuslavizki KH, Eary JF. PET imaging of osteosarcoma. J Nucl Med. 2003;44:930-942.PubMedGoogle Scholar
  27. 27.
    Eary JF, Conrad EU, Bruckner JD, et al. Quantitative [F-18] fluorodeoxyglucose positron emission tomography in pretreatment grading of sarcoma. Clin Cancer Res. 1998;4:1215-1220.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  1. 1.Department of Diagnostic Radiology, Division of Diagnostic ImagingThe University of Texas M.D. Anderson Cancer CenterHoustonUSA

Personalised recommendations