Correlation of Dynamic Contrast-Enhanced MR Imaging (DCE-MRI) and Histopathology in Osteosarcoma Response to Neoadjuvant Chemotherapy

Abstract

Background To evaluate the dynamic contrast-enhanced MRI (DCE-MRI) parameters for monitoring the neoadjuvant chemotherapy (NAC) response in osteosarcoma and correlate the parameters of histopathology specimens.Methods Patients with pathologically confirmed as osteosarcoma had three cycles of NAC administered. Dynamic MRI were performed on all patients before and after chemotherapy. Semi-quantitative and quantitative parameters were compared between the good response group (TNR ≥ 90 percent) and poor response group (TNR < 90 percent) using the histology response as the reference standard (tumor necrosis rate). The Mann-Whitney U test was used to assess the differences in DCE-MRI parameters before and after NAC. Results 15 patients were enrolled in this study of whom 3 patients lack of preoperative imaging examination, 2 patients inoperable to asess tumor necrosis rate and 1 had an allergy to a contrast agent. DCE-MRI of n = 9 patients were subsequently used for this study. Prior to chemotherapy, there were no statistically significant differences between the good response group and poor response group in TTP, AUC, MAX Slope, Ktrans, Kep, and Ve (P < 0.05). Following the completion of chemotherapy, the TTP, AUC, MAX Slope, Kep and Ktrans were significantly difference between the good response group and poor response group (P < 0.05). The Ve did not show significant difference between the two groups after the chemotherapy (P = 0,121).Conclusion DCE-MRI has effectively monitor the response to NAC during osteosarcoma treatment cycle.