Potential for Early Fracture Risk Assessment in Patients with Metastatic Bone Disease using Parametric Response Mapping of CT Images

Tomography : a Journal for Imaging Research
Benjamin A HoffCraig J Galbán

Abstract

Pathologic vertebral compression fractures (PVCF) cause significant morbidity in patients with bone metastases from breast cancer and other malignancies. Due to limitations of existing biochemical and imaging biomarkers, clinicians currently have no reliable metrics to identify patients with impending PVCF, impeding efforts to prevent this severe complication. To establish the feasibility of a new method for defining risk of PVCF, we retrospectively analyzed serial CT scans from five breast cancer patients using parametric response mapping (PRM) to quantify dynamic bone density changes that preceded an event. Vertebrae segmented from each scan were registered to vertebrae at the earliest time point (i.e. furthest from PVCF) and voxel classification accomplished using a predetermined threshold of change in HU values, resulting in relative volumes of increased (PRMHU+), decreased (PRMHU-), or unchanged (PRMHU0) attenuation. A total of seven PVCF were compared to un-diseased vertebrae in each patient serving as controls. Receiver operator curve (ROC) analysis identified optimal image acquisition and analysis times for group stratification. Bone density changes were visualized by an increasing trend in PRMHU+ as early as one year b...Continue Reading

Citations

Oct 26, 2016·American Journal of Respiratory and Critical Care Medicine·Elizabeth A BelloliVibha N Lama
Mar 13, 2020·Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society·Timothy A Damron, Kenneth A Mann
Oct 20, 2020·Current Osteoporosis Reports·Cari M WhyneMichael Hardisty

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