Purpose: This study aims to evaluate the value of contrast-enhanced ultrasound (CEUS) for assessing the response of osteosarcoma (OS) to neoadjuvant chemotherapy (NAC).Methods: A total of 84 patients with OS were recruited prospectively between July 2020 and April 2024.All patients received NAC and surgical treatment, and underwent CEUS before and after NAC, respectively.Time intensity curve was used to analyze tumor parameters, including time to peak intensity (TPI), peak intensity (PI), area under curve (AUC) and gradient of PI (Grad).Results: After NAC, the PI, AUC and Grad have decreased, and the degrees of decline were more significant in good response patients.Univariable and multivariable logistic regression analyses identified PI% as a significant and independent indicator of good response to NAC (OR = 1.064, 95% CI: 1.033, 1.097, p < 0.001).A cutoff value of 24.44% of PI% revealed the AUC, sensitivity, specificity, positive and negative predictive values were 0.848, 93.1%, 72.7%, 64.3%, 95.2%, respectively (p < 0.005).The negative likelihood ratio and positive likelihood ratio are 0.09 and 3.41.The repeatability of CEUS parameters, inter-observer and intra-observer were good.The Bland -Altman analysis of TPI, PI, AUC and Grad showed smaller biases and narrower consistency limits.Conclusion: CEUS can effectively evaluate the pathological response of OS after NAC, and PI% is a sensitive indicator.
Deng et al. (Sun,) studied this question.