PMID- 26771006
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20191120
IS  - 2379-1381 (Print)
IS  - 2379-139X (Electronic)
IS  - 2379-1381 (Linking)
VI  - 1
IP  - 2
DP  - 2015 Dec
TI  - Potential for Early Fracture Risk Assessment in Patients with Metastatic Bone 
      Disease using Parametric Response Mapping of CT Images.
PG  - 98-104
AB  - 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 
      (PRM(HU+)), decreased (PRM(HU-)), or unchanged (PRM(HU0)) 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 PRM(HU+) as early as one year before 
      fracture. PRM(HU-) demonstrated negligible changes over the course of the study. 
      These observations were consistent with ROC results, showing poor performance of 
      PRM(HU-) in stratifying PVCF versus control. As early as 6 months prior to PVCF, 
      PRM(HU+) was significantly larger (12.9 +/- 11.6%) compared to control vertebrae 
      (2.3 +/- 2.5%), with an AUC of 0.918 from a receiver operator curve analysis. Mean 
      HU changes were also significant between PVCF (+26.8 +/- 26.9%) and control (-2.2 +/- 
      22.0%) over the same period. PRM analysis of bone density changes using standard 
      CT imaging was sensitive for spatially resolving bone remodeling which preceded 
      structural failure in patients with breast cancer vertebral metastases.
FAU - Hoff, Benjamin A
AU  - Hoff BA
AD  - Department of Radiology, University of Michigan, Center for Molecular Imaging, 
      Ann Arbor, MI 48109, USA.
FAU - Toole, Michael
AU  - Toole M
AD  - Department of Internal Medicine, University of Michigan, Center for Molecular 
      Imaging, Ann Arbor, MI 48109, USA.
FAU - Yablon, Corrie
AU  - Yablon C
AD  - Department of Radiology, University of Michigan, Center for Molecular Imaging, 
      Ann Arbor, MI 48109, USA.
FAU - Ross, Brian D
AU  - Ross BD
AD  - Department of Radiology, University of Michigan, Center for Molecular Imaging, 
      Ann Arbor, MI 48109, USA.
FAU - Luker, Gary D
AU  - Luker GD
AD  - Department of Radiology, University of Michigan, Center for Molecular Imaging, 
      Ann Arbor, MI 48109, USA.
FAU - VanPoznak, Catherine
AU  - VanPoznak C
AD  - Department of Internal Medicine, University of Michigan, Center for Molecular 
      Imaging, Ann Arbor, MI 48109, USA.
FAU - Galban, Craig J
AU  - Galban CJ
AD  - Department of Radiology, University of Michigan, Center for Molecular Imaging, 
      Ann Arbor, MI 48109, USA.
LA  - eng
GR  - P01 CA085878/CA/NCI NIH HHS/United States
GR  - R01 CA136892/CA/NCI NIH HHS/United States
GR  - R35 CA197701/CA/NCI NIH HHS/United States
PT  - Journal Article
PL  - Switzerland
TA  - Tomography
JT  - Tomography (Ann Arbor, Mich.)
JID - 101671170
PMC - PMC4710140
MID - NIHMS747854
OTO - NOTNLM
OT  - Computed tomography
OT  - bone metastases
OT  - parametric response map
OT  - skeletal related event
OT  - vertebral compression fractures
COIS- Conflict of Interest: C.J.G. and B.D.R. may receive royalties from Imbio, LLC, 
      which has exclusively licensed the technology from the University of Michigan, 
      and B.D.R. has shares in Imbio, LLC.
EDAT- 2016/01/16 06:00
MHDA- 2016/01/16 06:01
PMCR- 2015/12/01
CRDT- 2016/01/16 06:00
PHST- 2016/01/16 06:00 [entrez]
PHST- 2016/01/16 06:00 [pubmed]
PHST- 2016/01/16 06:01 [medline]
PHST- 2015/12/01 00:00 [pmc-release]
AID - TOM-00154-15 [pii]
AID - 10.18383/j.tom.2015.00154 [doi]
PST - ppublish
SO  - Tomography. 2015 Dec;1(2):98-104. doi: 10.18383/j.tom.2015.00154.