Is 99mTc-MIBI scintigraphy a predictor of response to pre-operative neoadjuvant chemotherapy in Osteosarcoma?

Q3 Medicine
Mohammad Gharehdaghi, V. D. Dabbagh Kakhki, Alireza Khooei, Gholamhosein Novferesti, Alireza Hootkani, Mahdi Farzadnia, Ramin Sadeghi
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引用次数: 3

Abstract

Objectives: Multidrug resistance (MDR), which may be due to the over expression of P-glycoprotein (Pgp) and/or MRP, is a major problem in neoadjuvant chemotherapy of osteosarcoma. The aim of this study was to investigate the role of Tc-99m MIBI scan for predicting the response to pre-operative chemotherapy. Methods: Twenty-five patients (12 males and 13 females, aged between 8 and 52y) with osteosarcoma were studied. Before the chemotherapy, planar 99mTc-MIBI anterior and posterior images were obtained 10-min [tumor-to-background ratio: (T1/B1)10min] and 3-hr after tracer injection. After completion of chemotherapy, again 99mTc-MIBI scan was performed at 10-min after tracer injection. In addition to calculation of decay corrected tumor to background (T/B) ratios, using the 10-min and 3-hr images of the pre-chemotherapy scintigraphy, percent wash-out rate (WR%) of 99mTc-MIBI was calculated. Using the 10-min images of the pre- and post-chemotherapy scans, the percent reduction in uptake at the tumor site after treatment (Red%) was also calculated. Then after surgical resection, tumor response was assessed by percentage of necrosis. Results: All patients showed significant 99mTc-MIBI uptake in early images. Only 9 patients showed good response to chemotherapy (necrosis≥90%) while 16 patients were considered as non-responder (necrosis<90%). There was no statistical significant difference between non-responders and responders in (T1/B1)10min.There was a significant negative correlation between WR% and percentage of necrosis (P=0.001). On the other hand, there was a significant correlation between Red% and percentage of necrosis (P<0.001).There was also statistical significant difference in WR% and Red% between non-responders and responders (both P< 0.001). Conclusion: Washout rate of 99mTc-MIBI in pre-chemotherapy scintigraphy as well as Red% using pre- and post-chemotherapy MIBI scintigraphy are useful methods for predicting response to neoadjuvant chemotherapy.
99mTc-MIBI显像是骨肉瘤术前新辅助化疗反应的预测指标吗?
目的:多药耐药(MDR)是骨肉瘤新辅助化疗中的一个主要问题,可能是由于p -糖蛋白(Pgp)和/或MRP的过度表达。本研究的目的是探讨Tc-99m MIBI扫描在预测术前化疗反应中的作用。方法:25例骨肉瘤患者,男12例,女13例,年龄8 ~ 52岁。化疗前,示踪剂注射后10min[肿瘤与背景比:(T1/B1)10min]和3hr分别获得99mTc-MIBI平面前后像。化疗完成后,示踪剂注射后10分钟再次行99mTc-MIBI扫描。除了计算衰减校正后的肿瘤与背景的比值(T/B)外,使用化疗前闪烁成像的10分钟和3小时图像,计算99mTc-MIBI的百分比洗脱率(WR%)。使用化疗前和化疗后扫描的10分钟图像,也计算治疗后肿瘤部位摄取减少的百分比(红色%)。手术切除后,以坏死百分率评估肿瘤反应。结果:所有患者早期影像均显示99mTc-MIBI摄取显著。只有9例患者对化疗反应良好(坏死≥90%),16例患者认为无反应(坏死<90%)。无应答者和应答者在(T1/B1)10min内无统计学差异。WR%与坏死百分率呈显著负相关(P=0.001)。另一方面,Red%与坏死百分率有显著相关性(P<0.001)。无应答者和应答者的WR%和Red%差异有统计学意义(P均< 0.001)。结论:化疗前和化疗后MIBI显像的99mTc-MIBI洗脱率和Red%是预测新辅助化疗反应的有效方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Asia Oceania Journal of Nuclear Medicine and Biology
Asia Oceania Journal of Nuclear Medicine and Biology Medicine-Radiology, Nuclear Medicine and Imaging
CiteScore
1.80
自引率
0.00%
发文量
28
审稿时长
12 weeks
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