Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Fall;1(2):22-7.

Is (99m)Tc-MIBI scintigraphy a predictor of response to pre-operative neoadjuvant chemotherapy in Osteosarcoma?

Mohammad Gharehdaghi  1 , Vahid Reza Dabbagh Kakhki  2 , Alireza Khooei  3 , Gholamhosein Novferesti  4 , Alireza Hootkani  1 , Mahdi Farzadnia  3 , Ramin Sadeghi  2
Affiliations

Is (99m)Tc-MIBI scintigraphy a predictor of response to pre-operative neoadjuvant chemotherapy in Osteosarcoma?

Mohammad Gharehdaghi et al. Asia Ocean J Nucl Med Biol. 2013 Fall.

Abstract

Objectives: Multidrug resistance (MDR), which may be due to the over expression of P-glycoprotein (Pgp) and/or MRP, is a major problem in neoadjuvant chemotherapy of osteosarcoma. The aim of this study was to investigate the role of Tc-99m MIBI scan for predicting the response to pre-operative chemotherapy.

Methods: Twenty-five patients (12 males and 13 females, aged between 8 and 52y) with osteosarcoma were studied. Before the chemotherapy, planar (99m)Tc-MIBI anterior and posterior images were obtained 10-min [tumor-to-background ratio: (T1/B1)10min] and 3-hr after tracer injection. After completion of chemotherapy, again (99m)Tc-MIBI scan was performed at 10-min after tracer injection. In addition to calculation of decay corrected tumor to background (T/B) ratios, using the 10-min and 3-hr images of the pre-chemotherapy scintigraphy, percent wash-out rate (WR%) of (99m)Tc-MIBI was calculated. Using the 10-min images of the pre- and post-chemotherapy scans, the percent reduction in uptake at the tumor site after treatment (Red%) was also calculated. Then after surgical resection, tumor response was assessed by percentage of necrosis.

Results: All patients showed significant (99m)Tc-MIBI uptake in early images. Only 9 patients showed good response to chemotherapy (necrosis≥90%) while 16 patients were considered as non-responder (necrosis<90%). There was no statistical significant difference between non-responders and responders in (T1/B1)10min.There was a significant negative correlation between WR% and percentage of necrosis (P=0.001). On the other hand, there was a significant correlation between Red% and percentage of necrosis (P<0.001).There was also statistical significant difference in WR% and Red% between non-responders and responders (both P< 0.001).

Conclusion: Washout rate of (99m)Tc-MIBI in pre-chemotherapy scintigraphy as well as Red% using pre- and post-chemotherapy MIBI scintigraphy are useful methods for predicting response to neoadjuvant chemotherapy.

Keywords: 99mTc-MIBI; Neoadjuvant chemotherapy; Osteosarcoma; Therapy response.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Linear regression between WR% and percent of necrosis.
Figure 2
Figure 2
Linear regression between Red% and percent of necrosis.
See this image and copyright information in PMC

References

    1. Burak Z, Moretti JL, Ersoy O, Sanli U, Kantar M, Tamgac F, et al. 99mTc-MIBI imaging as a predictor of therapy response in osteosarcoma compared with multidrug resistance-associated protein and P-glycoprotein expression. J Nucl Med. 2003;44(9):1394–401. - PubMed
    1. Gomes CM, Welling M, Que I, Henriquez NV, van der Pluijm G, Romeo S, et al. Functional imaging of multidrug resistance in an orthotopic model of osteosarcoma using 99mTc-sestamibi. Eur J Nucl Med Mol Imaging. 2007;34(11):1793–803. - PubMed
    1. Taki J, Sumiya H, Asada N, Ueda Y, Tsuchiya H, Tonami N. Assessment of P-Glycoprotein in Patients with Malignant Bone and Soft-Tissue Tumors Using Technetium- 99m-MIB I Scintigraphy. J Nucl Med. 1998;39(7):1179–84. - PubMed
    1. Yapar Z, Kibar M, Yapar AF, Uguz A, Ozbarlas S, Gonlusen G. The value of Tc-99m-tetrofosmin scintigraphy in the assessment of P-glycoprotein in patients with malignant bone and soft-tissue tumors. Ann Nucl Med. 2003;17(6):443–9. - PubMed
    1. Baldini N, Scotlandi K, Serra M, Picci P, Bacci G, Sottili S, et al. P-glycoprotein expression in osteosarcoma: a basis for risk-adapted adjuvant chemotherapy. J Orthop Res. 1999;17(5):629–32. - PubMed

LinkOut - more resources