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Query: UMLS:C0029463 (osteosarcoma)
 16,637 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The purpose of this study was to determine the relationship of 18F-FDG uptake in the primary tumor at diagnosis, during therapy, and after therapy with a histologic response and event-free survival in pediatric and young adult patients with osteosarcoma (OS). Methods: Serial (baseline and 5 and 10 wk after start of therapy) 18F-FDG PET/CT imaging was performed in patients with newly diagnosed OS treated uniformly in a therapeutic trial at a single institution. Whole-body images were obtained approximately 1 h after injection of 18F-FDG. Logistic regression was used to study the association of tumor uptake and changes in SUVmax between 0, 5, and 10 wk for both clinical endpoints. Results: Thirty-four patients (17 males; median age, 12.2 y; age range, 6.8-19.1 y) underwent PET imaging; 25 (74%) had localized disease. Primary tumor locations included the femur (n = 17; 50%), tibia (n = 9; 26%), and humerus (n = 5; 15%). Logistic regression showed that SUVmax at 5 wk (P = 0.034) and 10 wk (P = 0.022) and percentage change from baseline at 10 wk (P = 0.021) were highly predictive of a histologic response. Using SUVmax of 4.04 at week 5, SUVmax of 3.15 at week 10, and 60% decrease from baseline at week 10 as cutoff values, we determined that the respective sensitivities were 0.93, 0.93, and 0.79 and that the respective specificities were 0.53, 0.71, and 0.76. Conclusion: SUVmax on routine images at 5 or 10 wk and percentage change in SUVmax from baseline to week 10 were metabolic predictors of a histologic response in OS. These findings may be useful in the early identification of patients who are responding poorly to therapy and may benefit from a change in treatment.
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PMID:18F-FDG Uptake During Early Adjuvant Chemotherapy Predicts Histologic Response in Pediatric and Young Adult Patients with Osteosarcoma. 2861 Dec 44

Although fibrous dysplasia is not considered a potentially premalignant disorder, malignant transformation occurs. Because of its rarity, radiographic features of malignantly transformed fibrous dysplasia on cross-sectional imaging modalities are less recognized, making diagnosis and differential diagnosis of the disease quite difficult in clinical practice. In this study, we analyzed the clinical characteristics, imaging features, pathology findings and surgery strategies of 19 malignantly transformed fibrous dysplasia. We found that there was significant male predominance in this specific cohort (13/6). While osteosarcoma (63.2%) was the most frequently occurring neoplasm secondary to fibrous dysplasia, other less commonly malignantly changed types included fasciculated sarcoma, malignant fibrous histiocytoma, fibrosarcoma and chondrosarcoma. We found that the diagnostic value of single modality imaging method, like conventional X-ray, computed tomography or non-contrast magnetic resonance imaging, was limited mainly because of a lack of whole-body metabolic information. In contrast, we highlighted that 99mTc-MDP SPECT/CT and/or 18F-FDG PET/CT scanning could exert a pivotal role in the management of malignantly transformed fibrous dysplasia by guiding precise biopsy and optimizing surgery options.
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PMID:Value of 99mTc-MDP SPECT/CT and 18F-FDG PET/CT scanning in the evaluation of malignantly transformed fibrous dysplasia. 2872 3

Osteosarcoma (OS) is the most frequent bone-forming malignancy in children and adolescents. Concerning its molecular landscape, there is no a direct relationship with a specific gene, but a combination of genetic events. A broad spectrum of activated oncogenes and downregulated suppressor genes has been already explored and considered crucial for its progressive pathogenesis. Mechanisms of gene deregulation include amplifications, point mutations, allelic losses and also epigenetic abnormalities such as aberrant promoter methylation. Although a significant progress in understanding the molecular nature of the OS has been achieved, its aggressive phenotype - characterized by high metastatic potential - remains unexplored. Novel targeted therapeutic strategies include monoclonal antibodies (mABs) and also tyrosine-kinase inhibitors (TKIs). Additionally, sophisticated and innovative diagnostic techniques, such as 18 fluorodeoxyglucose positron emission tomography plus CT (18F-FDG/PET/CT), provide critical data regarding its biological behavior. In the current paper, we present novel molecular and metabolic advances by analyzing OS genetic profile and biochemical microenvironment.
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PMID:Novel molecular and metabolic aspects in osteosarcoma. 2933 59

Second primary malignancy (SPM) is a severe issue for cancer survivors, particularly for osteosarcoma (OS) survivors. To date, the associations between subsequent SPM and OS have been well reported. Hematogenic and solid malignancies tend to occur following OS treatment. Reportedly, 2-[18F]-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) is mainly used in OS patients for initial cancer staging, to evaluate the response of neoadjuvant chemotherapy, and when recurrence or metastasis is clinically suspected. The present case report describes a 70-year-old man diagnosed with three primary malignancies: jaw OS, myelodysplastic syndrome and colorectal adenocarcinoma. To the best of our knowledge, this combination of malignancies has not been reported previously. Until now, there is no specific protocol of postoperative FDG-PET for OS patients. Few studies have described OS follow-up methods; therefore, there is no consensus on proper follow-up methods. In the present case report, the colorectal early-stage SPM was observed, without any symptoms, by FDG-PET/computed tomography. To avoid overlooking solid SPMs, it is suggested that FDG-PET should be performed in the long-term follow-up of OS patients.
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PMID:Triple primary malignancies of surface osteosarcoma of jaw, myelodysplastic syndrome and colorectal cancer as a second primary cancer detected by PET2-[18F]-fluoro-2-deoxy-D-glucose positron emission tomography: A case report. 2992 62

Extraskeletal osteosarcoma is a rare, high-grade soft tissue malignancy, accounting for approximately 1% of all soft tissue sarcomas. Despite the histologic resemblance to osteogenic osteosarcoma, it is considered as a distinct entity because of the differences in clinical behavior and response to treatment. Hence, imaging plays a vital role in establishing the nonskeletal origin of the tumor, differentiating it from osteogenic osteosarcoma. We present F-FDG PET/CT findings in a case of isolated primary extraskeletal osteosarcoma confirmed on histopathology.
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PMID:18F-FDG PET/CT in Isolated Primary Extraskeletal Osteosarcoma. 3027 8

A 20 year old man suffered severe right knee pain, especially when his right foot touched ground. The MRI findings suggested periosteal osteosarcoma, which led to a staging FDG PET/CT. The images showed not only a hypermetabolic right knee lesion but also focally elevated activity in select muscles, which was attributed to altered biomechanics. The resected lesion was pathologically proven as periosteal chondrosarcoma instead of periosteal osteosarcoma. In a follow-up period of 4 years after the surgery, there was no recurrent disease, nor any abnormality in the muscles which showed focal FDG activity on the initial FDG PET/CT.
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PMID:Unusual Focal Muscle FDG Activity Related to Altered Biomechanics. 3051 74

Fecal retention can be exacerbated in older patients, bedridden patients, as well as those receiving opioids analgesics or anticholinergic medications. It can lead to impaction, which can have serious consequences, sometimes even requiring surgical intervention. We describe herein the incidental detection of a giant hypometabolic fecaloma on PET/CT with F-FDG during the initial staging of a patient with osteosarcoma using opioids for pain management.
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PMID:Incidental Detection of a Giant Fecaloma on 18F-FDG PET/CT. 3169 9

Although trace amounts of radioactivity are routinely used to detect osteosarcoma, the use of larger therapeutic amounts of radiation is often an unrecognized opportunity to treat metastatic osteosarcoma. This chapter will review a number of approaches to use ionizing radiation in the form of injectable radiopharmaceuticals. Since bone metastases are a common pattern of metastatic spread of cancer in general, a number of bone-seeking radiopharmaceuticals have been developed and FDA approved for treatment of bone metastases. Although osteosarcoma, a bone-forming cancer, would seem ideally suited to be treated with bone seekers, patterns of relapse involving non-ossifying metastases remain a major problem to be overcome. Thus, this review will not only describe experience using a number of bone-seeking radiopharmaceuticals such as 153-samarium-EDTMP, 153-samarium-DOTMP, and 223-radium against osteosarcoma, but also approaches to identify patients who may benefit as well as some means to the improve overall efficacy including combination therapy with routine agents and using nuclear imaging to develop best strategy for use. These include imaging with not only 99mTc-MDP standard bone scans, but also 99mTc-MDP bone scans with SPECT CT, bone-specific sodium fluoride PET-CT (Na18F), and 18FDG-PET-CT. Accurate knowledge of oligometastatic active disease can facilitate more effective use of combination therapy, including radiosensitizers and local control measures, for example, stereotactic body radiotherapy (SBRT) and/or cryoablation to reduce disease burden as well as manage and prevent micrometastatic disease from growing and metastasizing. Finally, a new tumor-specific radiopharmaceutical, CLR 131, may also provide another radiopharmaceutical to treat both osteoblastic and non-ossifying areas of osteosarcoma.
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PMID:Radiopharmaceuticals for Treatment of Osteosarcoma. 3248 29

Osteosarcoma is usually F-FDG-avid. Here we report a case of an 18-year-old young man with widespread osteoblastic and slight osteolytic changes, which had diffusely increased Ga-DOTATATE uptake in the osseous lesions, whereas the F-FDG PET/CT was unrevealing. The final diagnosis is synchronous multifocal osteosarcoma based on the pathological, clinical, and imaging features.
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PMID:Diffuse Increased 68Ga-DOTATATE But Unimpressive 18F-FDG Osseous Activity in a Patient With Rapid-Progressing Synchronous Multifocal Osteosarcoma. 3279 43

We present the case of a 75-year-old man with osteosarcoma of the sternum in whom Ga-prostate-specific membrane antigen (PSMA) PET/CT showed high radiotracer activity in the primary tumor and metastatic lesions than F-FDG PET/CT. The present case shows that Ga-PSMA PET/CT is very useful for staging of osteosarcoma due to in vivo expression of PSMA. Ga-PSMA PET/CT can have potential effects on prognosis and in response assessment following treatment in osteosarcoma. The use of PSMA-targeted radioligand treatments may be beneficial especially in metastatic chemorefractory osteosarcoma.
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PMID:Is 68Ga-Prostate-Specific Membrane Antigen PET/CT Superior than 18F-FDG PET/CT for Evaluation of Metastatic Osteosarcoma? 3303 Dec 32


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