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Quantitative diffusion-weighted magnetic resonance imaging assessment of chemotherapy treatment response of pediatric osteosarcoma and Ewing sarcoma malignant bone tumors

  • Andrew J. Degnan
    Correspondence
    Corresponding author at: Department of Radiology, The Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, United States.
    Affiliations
    Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA, United States

    Department of Pediatric Radiology, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, United States

    Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, PA, United States
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  • Author Footnotes
    1 Address: Department of Radiology, University of Pittsburgh Medical Center, 200 Lothrop St, Suite E174, Pittsburgh, PA 15213, United States.
    Chul Y. Chung
    Footnotes
    1 Address: Department of Radiology, University of Pittsburgh Medical Center, 200 Lothrop St, Suite E174, Pittsburgh, PA 15213, United States.
    Affiliations
    Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA, United States

    Department of Pediatric Radiology, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, United States
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  • Author Footnotes
    2 Address: Department of Pediatric Radiology, Children's Hospital of Pittsburgh, One Children's Hospital Drive, 4401 Penn Avenue, Pittsburgh, PA 15224, United States.
    Amisha J. Shah
    Footnotes
    2 Address: Department of Pediatric Radiology, Children's Hospital of Pittsburgh, One Children's Hospital Drive, 4401 Penn Avenue, Pittsburgh, PA 15224, United States.
    Affiliations
    Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA, United States

    Department of Pediatric Radiology, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, United States
    Search for articles by this author
  • Author Footnotes
    1 Address: Department of Radiology, University of Pittsburgh Medical Center, 200 Lothrop St, Suite E174, Pittsburgh, PA 15213, United States.
    2 Address: Department of Pediatric Radiology, Children's Hospital of Pittsburgh, One Children's Hospital Drive, 4401 Penn Avenue, Pittsburgh, PA 15224, United States.

      Highlights

      • Apparent diffusion coefficient values within pediatric bone tumors increase substantially following chemotherapy.
      • Physical tumor measurements alone may not always accurately reflect treatment response.
      • The average apparent diffusion coefficient value best predicts treatment status.

      Abstract

      Objective

      Assessment of tumor response to chemotherapy is essential in managing malignant pediatric bone tumors prior to resection.

      Subjects and methods

      Pre-chemotherapy and post-chemotherapy osteosarcoma and Ewing sarcoma cases (n = 18) were analyzed with apparent diffusion coefficient (ADC) values measured by two readers.

      Results

      Treated tumors demonstrated significantly greater ADC values compared to untreated tumors (p < 0.001). Intraclass correlation coefficients ranged between 0.858 and 0.935. No significant tumor volume differences were observed. Regression analysis demonstrated average ADC as the best predictor of treatment.

      Conclusions

      Our study suggests that ADC values may be useful for evaluating chemotherapeutic response of malignant pediatric bone tumors.

      Keywords

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