Soft tissue variations influence HR-pQCT density measurements in a spatially dependent manner

Wu, Po-Hung; Gupta, Tanvi; Chang, Hanling; Petrenko, Dimitry M; Schafer, Anne L.; Kazakia, Galateia J.

doi:10.1016/j.bone.2020.115505

Cited by 8 publications

(3 citation statements)

References 36 publications

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“…The importance of giving RAI to those patients is also reinforced by the fact that, in our cohort, patients with I131 treatment were similar at baseline to those who didn't receive it (similar data for TNM stage, metastases in other locations and pulmonary metastases, which were the factors associated with mortality in our study). The uptake of I131 by BMs was also significant as a protective factor in the univariate analysis, a result consistent with those of other authors ( 6 , 14 , 17 , 28 , 29 ). Regarding the combination of I131 with other treatments, this was not shown to improve survival in our cohort, contrary to the results of other studies ( 2 , 4 , 30 , 31 , 32 , 33 , 34 , 35 ).…”

Section: Discussionsupporting

confidence: 91%

Bone metastases from differentiated thyroid cancer: characteristics and prognostic factors in a multicenter series

Piñar-Gutiérrez¹,

Romero-Lluch²,

Dueñas-Disotuar

et al. 2023

European Thyroid Journal

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Objective: To describe the characteristics, survival and prognostic factors of a cohort of patients with bone metastases (BM) from differentiated thyroid carcinoma (DTC). Methods: This was a multicenter retrospective observational study including patients diagnosed with BM from DTC between 1980-2021. A Cox-regression was performed to study prognostic factors for 5- and 10-year survival. Kaplan-Meier and log-rank tests were performed for survival analysis and comparison between groups. Results: Sixty-three patients were evaluated. Median follow-up from BM diagnosis was 35(15-68) months. 30(48.4%) patients presented with synchronous BM. Regarding histology, 38(60.3%) had the papillary variant. BM were multiple in 32(50.8%) patients. The most frequent location was the spine (60.3%). Other metastases were present in 77.8%, mainly pulmonary (69.8%). Concerning treatment, 54(85.9%) patients received I131, with BM uptake in 31(49.2%), and 25(39.7%) received treatment with multikinase inhibitors. Regarding complications, 34(54%) patients had skeletal-related events, 34(54%) died and 5- and 10-year overall survival was 42.4% and 20.4%, respectively. Significant prognostic factors in the multivariate analysis were the presence of lymph node involvement (HR 2.916 (95% CI 1.013-8.391);p=0.047) and treatment with I131 (HR 0.214 (95% CI 0.069-0.665);p=0.008) at 5 years, the presence of other metastases (HR 6.844. 95% CI 1.017-46.05;p=0.048) and treatment with I131 (HR 0.23 (95% CI 0.058-0.913);p=0.037) at 10 years. Conclusions: Our study reflects the management of patients with bone metastases from differentiated thyroid carcinoma in real clinical practice in several centers in southern Spain. Overall survival at 5 and 10 years was lower in patients who were not treated with I131, had nodal involvement and/or had other metastases.

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Section: Discussionsupporting

confidence: 91%

Bone metastases from differentiated thyroid cancer: characteristics and prognostic factors in a multicenter series

Piñar-Gutiérrez¹,

Romero-Lluch²,

Dueñas-Disotuar

et al. 2023

European Thyroid Journal

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“…This technique also allows the calculation of the amount of adipose tissue in the bone marrow, which is usually increased in patients with obesity and in the older subjects and which has been related to bone microstructural deterioration and the presence of non-vertebral fractures [ 152 ]. Like DXA, the accuracy of this test is also influenced by the thickness of the soft tissue [ 153 ].…”

Section: Difficulties In the Diagnosis Of Osteoporosis And Prediction...mentioning

confidence: 99%

Obesity and Bone Health: A Complex Relationship

Piñar-Gutiérrez

García-Fontana

et al. 2022

IJMS

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Recent scientific evidence has shown an increased risk of fractures in patients with obesity, especially in those with a higher visceral adipose tissue content. This contradicts the old paradigm that obese patients were more protected than those with normal weight. Specifically, in older subjects in whom there is a redistribution of fat from subcutaneous adipose tissue to visceral adipose tissue and an infiltration of other tissues such as muscle with the consequent sarcopenia, obesity can accentuate the changes characteristic of this age group that predisposes to a greater risk of falls and fractures. Other factors that determine a greater risk in older subjects with obesity are chronic proinflammatory status, altered adipokine secretion, vitamin D deficiency, insulin resistance and reduced mobility. On the other hand, diagnostic tests may be influenced by obesity and its comorbidities as well as by body composition, and risk scales may underestimate the risk of fractures in these patients. Weight loss with physical activity programs and cessation of high-fat diets may reduce the risk. Finally, more research is needed on the efficacy of anti-osteoporotic treatments in obese patients.

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“…In particular, beam hardening is a common artifact in HR-pQCT resulting from overattenuating lower-energy photons. While this can be attributed to numerous phenomena, in practice, it is most commonly a result of large body habitus or extreme variation in each subject's body composition [ 31 ].…”

Section: Computed Tomography (Ct)mentioning

confidence: 99%

The Application of Advanced Bone Imaging Technologies in Sports Medicine

Tadros,

Epsley,

Mehta

et al. 2023

Radiology Research and Practice

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Until recently, the evaluation of bone health and fracture risk through imaging has been limited to dual-energy X-ray absorptiometry (DXA) and plain radiographs, with a limited application in the athletic population. Several novel imaging technologies are now available for the clinical assessment of bone health, including bone injury risk and healing progression, with a potential for use in sports medicine. Among these imaging modalities is high-resolution peripheral quantitative computed tomography (HR-pQCT) which is a promising technology that has been developed to examine the bone microarchitecture in both cortical and trabecular bone at peripheral anatomical sites. Technologies that do not expose patients to ionizing radiation are optimal, particularly for athletes who may require frequent imaging. One such alternative is diagnostic ultrasound, which is preferable due to its low cost and lack of radiation exposure. Furthermore, ultrasound, which has not been a common imaging modality for monitoring fracture healing, has been shown to potentially demonstrate earlier signs of union compared to conventional radiographs, including callus mineralization and density at the healing site. Through the use of conventional magnetic resonance imaging (MRI), finite element analysis (FEA) can be used to simulate the structural and mechanical properties of bone. On the other hand, the ultrashort echo time (UTE) MRI can evaluate cortical bone quality by detecting water bound to the organic bone matrix and free water, providing important information about bone porosity. Several novel bone imaging techniques originally developed for osteoporosis assessment have great potential to be utilized to improve the standard of care in bone fracture risk assessment and healing in sports medicine with much greater precision and less adverse radiation exposure.

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Soft tissue variations influence HR-pQCT density measurements in a spatially dependent manner

Cited by 8 publications

References 36 publications

Bone metastases from differentiated thyroid cancer: characteristics and prognostic factors in a multicenter series

Bone metastases from differentiated thyroid cancer: characteristics and prognostic factors in a multicenter series

Obesity and Bone Health: A Complex Relationship

The Application of Advanced Bone Imaging Technologies in Sports Medicine

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