Monitoring Osteosarcoma Chemotherapy Response with PET/CT

Osteosarcoma is a rare but aggressive form of bone cancer requiring early, effective treatment for improved survival outcomes. Recent research has shown that [18F]FDG PET/CT imaging can serve as a reliable early indicator of how patients respond to neoadjuvant chemotherapy, allowing clinicians to personalize treatment strategies in real time.

A study published in EJNMMI Research evaluated whether PET/CT scans after one and two cycles of chemotherapy could predict event-free survival (EFS) in patients with extremity osteosarcoma. The findings suggest that osteosarcoma PET/CT imaging plays a valuable role in predicting clinical outcomes and optimizing care.

For providers seeking to integrate early response monitoring into oncology workflows, Shared Medical Services offers flexible, high-sensitivity mobile PET/CT imaging across the U.S.

This retrospective analysis included 73 patients with AJCC stage II extremity osteosarcoma, all of whom underwent:

• • Two cycles of neoadjuvant chemotherapy
  • Surgical resection of the primary tumor
  • Postoperative adjuvant chemotherapy
  • Multiple PET/CT scans before and after treatment cycles

Researchers used SUVmax (Standardized Uptake Value) as the primary metric to evaluate glucose metabolism in tumors and its correlation with patient outcomes.

49.3% of patients had poor histologic response to chemotherapy
23.3% experienced metastasis or local recurrence
Higher SUVmax values after treatment correlated with poorer survival outcomes

PET/CT Predictive Markers Identified:

• SUV2: Patients with SUVmax > 5.9 (post-second scan) had significantly worse outcomes
• SUV01: Less than -39.8% change between baseline and first scan = poor response
• SUV02: Less than -54.1% reduction between baseline and second scan = increased risk

These indicators allow clinicians to identify non-responders early and consider alternative or intensified therapies.

The ability to use PET/CT for chemotherapy monitoring brings several benefits to oncology:

• Early scan results can help stratify patients by risk
• Poor responders may receive tailored or intensified treatments
• Real-time adjustments can improve event-free survival outcomes

As personalized medicine becomes the standard of care, tools like PET/CT imaging are critical for precision oncology.

Sources:
Lee, I., Byun, B., Lim, I. et al. (2021). Early Response Monitoring of Neoadjuvant Chemotherapy Using [18F]FDG PET/CT in Osteosarcoma. EJNMMI Research.

Media Contact:
Blake Kenney
Senior Marketing Specialist
Shared Medical Services, Inc.
Phone: (608) 910-1332
Email: contactsms@sharedmed.com