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ORIGINAL RESEARCH article
Front. Oncol.
Sec. Cancer Imaging and Image-directed Interventions
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1514560
This article is part of the Research Topic Advancing Cancer Imaging Technologies: Bridging the Gap from Research to Clinical Practice Volume II View all 4 articles
Presence of a fat layer after neoadjuvant chemotherapy as an indicator of prognosis in osteosarcoma
Provisionally accepted- First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
Objective: To evaluate the potential of magnetic resonance imaging (MRI) to monitor the response in patients with osteosarcoma receiving chemotherapy and to assess the correlation between the presence of a fat layer surrounding the tumor after neoadjuvant chemotherapy and prognosis. Methods: Twenty-eight patients with osteosarcoma were included in this retrospective study. All patients underwent chemotherapy and surgery. MRI images of the patients were evaluated before and after neoadjuvant chemotherapy. The prognostic factors included histological response and alkaline phosphatase (ALP) level. Relapse, and survival at follow-up were defined as patient outcomes. The log-rank test was used to compare these factors with various MRI characteristics (e.g. change in maximum lesion length before and after chemotherapy, change in maximum edema, and fat layer presence after chemotherapy). Results: The median time of follow-up was 64.3 ± 41.5 months. The 3-and 5-year event-free survival rates were 75.0% and 67.9%, respectively. ALP levels after chemotherapy were associated with tumor necrosis (p = 0.01). Change in maximum lesion length (p = 0.044; odds ratio [OR] = 0.035; confidence interval [CI]: 0.01-0.911,) was a predictor of survival. Changes in edema on T2-weighted sequences (p = 0.979; OR = 0.989, CI: 0.437-2.242) were not significant. The presence of a fat layer (p = 0.013; OR = 0.000; confidence CI: 0.000-0.018) predicted good event-free survival. Conclusions: The presence of a fat layer correlated with good prognosis in patients with osteosarcoma. MRI characteristics in the early stages could help to inform decision-making about treatment strategy.
Keywords: MRI, Osteosarcoma, chemotherapy, prognosis, Survival
Received: 21 Oct 2024; Accepted: 17 Mar 2025.
Copyright: © 2025 Huang and Xie. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Zengru Xie, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
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