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Oncology-Clinical Diagnosis: Solid TumorsSarcoma |
1 Nuclear Medicine, Kanazawa University Hospital, Kanazawa, Japan; 2 Orthopedic Surgery, Kanazawa University Graduate School of Medical Sciense, Kanazawa, Japan; 3 Biotracer Medicine, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
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Objectives: To assess whether Tc-99m-MIBI imaging at the early course of chemotherapy can predict final chemotherapeutic response as precisely as the imaging at final course of the therapy in malignant bone and soft tissue tumors (MBST).
Methods: 62 patients with MBST were performed Tc-MIBI angiography and 15 min-imaging before and after the 2nd (n=19) 3rd (n=61) and 5th (n=56) chemotherapy cycle. Tumor resection was performed after 5 cycles of chemotherapy and the effect of the therapy was determined by histological analysis: < 90% and 90~100% necrosis were judged as no change (NC) and good response (GR), respectively. The % reduction of MIBI perfusion index (PI) and uptake ratio (UR) during and after therapy were compared with the histologic response.
Results: Based on the pathological examinations, 30 patients showed GR and 32 showed NC. To evaluate the diagnostic performance of each parameter, receiver operator characteristic (ROC) curves were generated and the areas under the curves (Az) were calculated. The Az of ROC in the % reduction of PI at 2nd, 3rd, and 5th chemotherapy were 0.81, 0.83, 0.80, respectively (P=ns). The Az of ROC in the % reduction of UR at 2nd, 3rd, and 5th chemotherapy were 0.90, 0.94, 0.94, respectively (P=ns).
Conclusions: Tc-99m-MIBI imaging performed in the early course of chemotherapy is considered to have an accurate and similar diagnostic performance compared to the imaging at final chemotherapy cycle for the prediction of the final chemotherapeutic response in patients with MBST.
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