Association of Osteosarcoma Necrotic Volumes with Tumour Size and Lung Metastasis: Revealed by Magnetic Resonance Imaging

M Nor Azam, NM Nik Munirah, W Zulmi

Hong Kong J Radiol 2011;14:73-7

Objective: Osteosarcoma is the most frequent skeletal malignancies in children and adolescents. Studies indicate that hypoxia of such solid tumours has a major prognostic impact; severe and long-lasting hypoxia results in tumour necrosis. Therefore presence of necrosis can be correlated with prognosis. This study was designed to determine any correlation between tumour necrosis volume, tumour volume, and lung metastasis.

Methods: This was a cross-sectional study involving 33 patients with osteosarcoma admitted to the Hospital Universiti Sains Malaysia from October 2001 to September 2008. They each underwent magnetic resonance imaging and their respective measurements of tumour volume and tumour necrosis volume were done using OsiriX software. Computed tomography was used to detect lung metastasis.

Results: A total of 73% of patients presented with lung metastasis. There was no significant association between tumour necrosis volume and lung metastasis (p = 0.115). There was a significant association between tumour volume and lung metastasis (p = 0.036). A significant correlation was noted between tumour necrosis volume and tumour volume (p < 0.001).

Conclusion: Tumour necrosis volume cannot be used as prognostic factor. There was, however, an association between tumour volume and prognosis.

中文摘要

骨肉瘤的腫瘤壞死區域體積與腫瘤大小及肺轉移的關係：磁共振表現

M Nor Azam、NM Nik Munirah、W Zulmi

目的：骨肉瘤是小童及青年人最常見的惡性骨腫瘤。研究指出這類腫瘤缺氧會影響預後，而嚴重及 長時間缺氧會導致腫瘤壞死，所以說腫瘤壞死與預後有關。本研究嘗試探討腫瘤壞死區域的體積、 腫瘤大小及肺轉移的關係。

方法：參與者為2001年10月至2008年9月期間入住馬來西亞理科大學醫院的33名骨肉瘤患者。每名病 人都會接受磁力共振造影，得出的腫瘤壞死區域體積和腫瘤大小均會用OsiriX軟體分析，並用CT觀 察病人肺轉移的情況。

結果：共有73%的病人出現肺轉移。結果顯示，腫瘤壞死區域體積和肺轉移並無明顯關係（p = 0.115），可是腫瘤大小和肺轉移明顯相關（p = 0.036），而腫瘤壞死區域體積和腫瘤大小亦有顯著 關係（p < 0.001）。

結論：腫瘤壞死區域體積不能被用作預後。但腫瘤大小可被用作預後。