CHANGES IN TUMOR PERFUSION INDUCED BY CHEMOTHERAPY IN BONE SARCOMAS -COLOR DOPPLER FLOW IMAGING COMPARED WITH CONTRAST-ENHANCED MR-IMAGINGAND 3-PHASE BONE-SCINTIGRAPHY

PURPOSE: To prospectively evaluate color Doppler flow imaging (CDFI) w ith spectral analysis versus dynamic gadolinium-enhanced magnetic reso nance (MR) imaging and three-phase bone scintigraphy in monitoring the effect of chemotherapy on bone sarcomas. MATERIALS AND METHODS: Seven teen osteosarcomas and five Ewing sarcomas were examined with these im aging techniques before and after chemotherapy. Results were compared with the histopathologic response. RESULTS: Before chemotherapy, high systolic Doppler frequency shifts (DFSs) and/or low-impedance Doppler signals were found in all but one tumor. Resistive indexes (RIs) in tu mor-feeding arteries were substantially lower than in contralateral no rmal arteries. After chemotherapy, DFSs disappeared in five of seven g ood respondents and remained substantial in all but one poor responden t. RIs increased substantially in all good respondents and decreased o r showed minor changes only in all but one poor respondent. CONCLUSION : CDFI with spectral analysis has an advantage over the other two tech niques in monitoring the efficacy of chemotherapy in bone sarcomas bec ause of its superior accuracy, noninvasive nature, availability, and l ow cost.