Treatment Planning and Fracture Prediction in Patients with Skeletal Metastasis with CT-Based Rigidity Analysis

Clinical Cancer Research : an Official Journal of the American Association for Cancer Research
Ara NazarianBrian D Snyder

Abstract

Pathologic fractures could be prevented if reliable methods of fracture risk assessment were available. A multicenter prospective study was conducted to identify significant predictors of physicians' treatment plan for skeletal metastasis based on clinical fracture risk assessments and the proposed CT-based Rigidity Analysis (CTRA). Orthopedic oncologists selected a treatment plan for 124 patients with 149 metastatic lesions based on the Mirels method. Then, CTRA was performed, and the results were provided to the physicians, who were asked to reassess their treatment plan. The pre- and post-CTRA treatment plans were compared to identify cases in which the treatment plan was changed based on the CTRA report. Patients were followed for a 4-month period to establish the incidence of pathologic fractures. Pain, lesion type, and lesion size were significant predictors of the pre-CTRA plan. After providing the CTRA results, physicians changed their plan for 36 patients. CTRA results, pain, and primary source of metastasis were significant predictors of the post-CTRA plan. Follow-up of patients who did not undergo fixation resulted in 7 fractures; CTRA predicted these fractures with 100% sensitivity and 90% specificity, whereas the M...Continue Reading

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Citations

May 30, 2015·Clinical Orthopaedics and Related Research·Ara NazarianBrian D Snyder
Feb 28, 2016·Clinical Orthopaedics and Related Research·Daniel M LermanMichelle Ghert
Feb 15, 2017·The Journal of Bone and Joint Surgery. American Volume·Arun AnejaRex C Haydon
Mar 2, 2017·JBJS Reviews·Michael B O'SullivanTessa Balach
Feb 22, 2017·Hip International : the Journal of Clinical and Experimental Research on Hip Pathology and Therapy·Sam C JonasRichard P Baker
Nov 6, 2018·The Journal of the American Academy of Orthopaedic Surgeons·Christopher N JohnsonMatthew J Thompson
Jul 26, 2019·The Journal of the American Academy of Orthopaedic Surgeons·Jad M El AbiadAdam S Levin
Mar 13, 2020·Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society·Timothy A Damron, Kenneth A Mann
Sep 25, 2018·Frontiers in Endocrinology·Henry SoeharnoPeter F Choong
May 1, 2020·The Bone & Joint Journal·A SternheimZ Yosibash
Apr 6, 2021·Seminars in Ultrasound, CT, and MR·Colleen M CostelloeJohn E Madewell
Aug 13, 2020·Orthopaedics & Traumatology, Surgery & Research : OTSR·Vincent CrennUNKNOWN members of the So.F.C.O.T.

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