3D bone texture analysis as a potential predictor of radiation-induced insufficiency fractures

Abstract

Background: The aim of our work is to assess the potential role of texture analysis (TA), applied to computed tomography (CT) simulation scans, in relation to the development of insufficiency fractures (IFs) in patients undergoing radiation therapy (RT) for pelvic malignancies. Methods:We analyzed patients undergoing pelvic RT from Jan-2010 to Dec-2016, 31 of whom had developed IFs of the pelvis. We analyzed CT simulation scans using LifeX Software © , and in particular we selected three regions of interest (ROI): L5 body, the sacrum and both the femoral heads. The ROI were automatically contoured using the treatment planning software Raystation © . TA parameters included parameters from the gray-level histogram, indices from sphericity and from the matrix of GLCM (gray level co-occurrence matrix). The IFs patients were matched (1:1 ratio) with control patients who had not developed IFs, and were matched for age, sex, type of tumor, menopausal status, RT dose and use of chemotherapy. Univariate and multivariate analyses (logistic regression) were used for statistical analysis.Results: Significant TA parameters on univariate analysis included both parameters from the histogram distribution, as well from the matrix of GLCM. On logistic regression analysis the significant parameters Conclusions: In our experience, 3D-bone CT TA can be used to stratify the risk of the patients to develop radiation-induced IFs. A prospective study will be conducted to validate these findings.

Discordance in diagnosis of osteoporosis by quantitative computed tomography and dual-energy X-ray absorptiometry in Chinese elderly men

“…Recently, some researchers have been studying the application of computed tomography in measuring bone strength and predicting fracture [22], [23], [24]. These studies have shown that in addition to measuring BMD for detecting osteoporosis, QCT has the unique ability to provide information on anatomical morphology and get many quantitative parameters about bone health with a single scan, without causing pain due to movement especially in the elderly and those with fractures (such as identifying the details of vertebral fractures [25]).…”

Radiomics in the Setting of Neoadjuvant Radiotherapy: A New Approach for Tailored Treatment

“…This analysis can use multiple mathematical models that are aimed to provide quantitative parameters within a selected image, which are called texture features. TA is performed employing a computer quantification of both the gray-level intensity and position of the pixels, and its use is being investigated in several fields [ 10 , 11 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 ]. More recently, a different approach to TA was developed, taking into consideration the variations in TA parameters at different acquisition times.…”

Radiomics predicts survival of patients with advanced non‑small cell lung cancer undergoing PD‑1 blockade using Nivolumab

“…TA is performed by means of a computer quantification of both gray-level intensity, position of pixels, and its use is being investigated in several fields (16)(17)(18)(19)(20)(21)(22)(23).…”