Imaging of malignant tumours of the long bones in children: monitoring response to neoadjuvant chemotherapy and preoperative assessment

Pediatr Radiol. 2004 Aug;34(8):595-605. doi: 10.1007/s00247-004-1192-x. Epub 2004 Apr 22.


This review focuses on imaging of osteosarcoma and Ewing's sarcoma of the long bones in children during preoperative neoadjuvant chemotherapy. Morphological criteria on plain films and conventional static MRI are insufficiently correlated with histological response. We review the contribution of dynamic MRI, diffusion-weighted MR and nuclear medicine (18FDG-PET) to monitor tumoural necrosis. MRI is currently the best method to evaluate local extension prior to tumour resection, especially to assess the feasibility of conservative surgery. Quantitative models in dynamic MRI and 18FDG-PET are currently being developed in order to find new early prognostic criteria, but for the time being, treatment protocols are still based on the gold standard of histological response.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Bone Neoplasms / drug therapy
  • Bone Neoplasms / pathology*
  • Bone Neoplasms / surgery
  • Chemotherapy, Adjuvant
  • Child
  • Humans
  • Magnetic Resonance Imaging*
  • Necrosis
  • Osteosarcoma / drug therapy
  • Osteosarcoma / pathology*
  • Osteosarcoma / surgery
  • Preoperative Care
  • Prognosis
  • Remission Induction
  • Sarcoma, Ewing / drug therapy
  • Sarcoma, Ewing / pathology
  • Sarcoma, Ewing / surgery
  • Tibia / diagnostic imaging
  • Tibia / drug effects
  • Tibia / pathology
  • Tomography, Emission-Computed*