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- Title
Bone texture analysis using CT-simulation scans to individuate risk parameters for radiation-induced insufficiency fractures.
- Authors
Nardone, V.; Tini, P.; Carbone, S. F.; Grassi, A.; Biondi, M.; Sebaste, L.; Carfagno, T.; Vanzi, E.; De Otto, G.; Battaglia, G.; Rubino, G.; Pastina, P.; Belmonte, G.; Mazzoni, L. N.; Banci Buonamici, F.; Mazzei, M. A.; Pirtoli, L.
- Abstract
Summary: This study deals with the role of texture analysis as a predictive factor of radiation-induced insufficiency fractures in patients undergoing pelvic radiation. Introduction: This study aims to assess the texture analysis (TA) of computed tomography (CT) simulation scans as a predictive factor of insufficiency fractures (IFs) in patients with pelvic malignancies undergoing radiation therapy (RT). Methods: We performed an analysis of patients undergoing pelvic RT from January 2010 to December 2014, 24 of whom had developed pelvic bone IFs. We analyzed CT-simulation images using ImageJ macro software and selected two regions of interest (ROIs), which are L5 body and the femoral head. TA parameters included mean ( m), standard deviation (SD), skewness (sk), kurtosis ( k), entropy ( e), and uniformity ( u). The IFs patients were compared (1:2 ratio) with controlled patients who had not developed IFs and matched for sex, age, menopausal status, type of tumor, use of chemotherapy, and RT dose. A reliability test of intra- and inter-reader ROI TA reproducibility with the intra-class correlation coefficient (ICC) was performed. Univariate and multivariate analyses (logistic regression) were applied for TA parameters observed both in the IFs and the controlled groups. Results: Inter- and intra-reader ROI TA was highly reproducible (ICC > 0.90). Significant TA parameters on paired t test included L5 m ( p = 0.001), SD ( p = 0.002), k ( p = 0.006), e (p = 0.004), and u ( p = 0.015) and femoral head m ( p < 0.001) and SD ( p = 0.001), whereas on logistic regression analysis, L5 e ( p = 0.003) and u ( p = 0.010) and femoral head m ( p = 0.027), SD ( p = 0.015), and sex ( p = 0.044). Conclusions: In our experience, bone CT TA could be correlated to the risk of radiation-induced IFs. Studies on a large patient series and methodological refinements are warranted.
- Subjects
DIAGNOSIS of bone fractures; COMPUTED tomography; MULTIVARIATE analysis; PELVIC bones; PELVIC tumors; RADIATION injuries; RADIOTHERAPY; STATISTICS; T-test (Statistics); LOGISTIC regression analysis; INTRACLASS correlation
- Publication
Osteoporosis International, 2017, Vol 28, Issue 6, p1915
- ISSN
0937-941X
- Publication type
Article
- DOI
10.1007/s00198-017-3968-5