We studied image diagnosis for assessing the effects of preoperative treatment of osteosarcoma in 20 patients. Image diagnosis included X-ray, CT, MRI, angiography and bone scintigraphy which were carried out immediately before and after preoperative treatment in every patient. Histological effects by preoperative treatment were graded according to tumor necrosis, and the histological examination revealed partial response (PR) in 5 patients, no change (NC) in 10 and progressive disease (PD) in 5. No patient showed a complete response (CR). The valuable diagnostic indicators relating to the histological effects were as follows; decrease of tumor volume in MRI, disappearance of neovascularity in angiography, and marked decrease of 99Tc-MDP uptake in bone scintigraphy. X-ray and CT were not useful for evaluating the histological effects. All the findings in MRI, angiography and bone scintigraphy were observed only in the PR patients. In the NC patients, MRI and angiography displayed the findings, however, bone scintigraphy did not. The PD patients did not show any of the findings.
These results indicate that the grade of the histological effects by preoperative treatment could be evaluated by MRI, angiography and bone scintigraphy.
