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Bone Density as a Marker of Response to Radiotherapy in Bone Metastatic Lesions: A Review of the Published Data

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ABSTRACT

Metastases to the bone are presenting in a great percentage of patients with cancer, causing a variety of symptoms, affecting the quality of life and survival of patients. A multidisciplinary approach from different health providers is required for treatment, including radiation oncologists, medical oncologists and surgeons. The role of radiotherapy in the management of bone metastases has long been established through multiple randomized trials. The estimation of response to the therapy is subjective and is based on the palliation of the symptoms that the patients report. However, a quantification of the tumor burden and response to the treatment with the use of an objective method to measure those parameters is a clinical expectation in oncology. The change in bone density in affected areas (mainly lytic) after local radiotherapy, representing the cellular changes that have occurred, is a promising marker of response to treatment.

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First-order statistics as an image processing technique for the evaluation of recalcification of bone lytic metastasis at the femur after radiotherapy. Mean value and energy (MVGLH, EGLH) at baseline (EGLH = 0.19, MVGLH = 155.1) and six months after initiation of multimodality treatment (EGLH = 0.17, MVGLH = 173.3). P(I) refers to the probability of intensity (I).
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ijms-17-01391-f001: First-order statistics as an image processing technique for the evaluation of recalcification of bone lytic metastasis at the femur after radiotherapy. Mean value and energy (MVGLH, EGLH) at baseline (EGLH = 0.19, MVGLH = 155.1) and six months after initiation of multimodality treatment (EGLH = 0.17, MVGLH = 173.3). P(I) refers to the probability of intensity (I).

Mentions: As mineral is lost from the lytic metastases, the distribution of pixel intensities is shifted and becomes more concentrated at the lower gray levels. As a result, the mean value decreases and the energy increases in the osteolytic regions. After the evaluation of the images by expert radiologists, significant changes were detected. In detail, there was an 11.08% (95% CI 10.21, 11.93) mean reduction of energy in the gray-level histogram and an 11.63% (95% CI 10.96, 12.29) increase in the mean value of the gray-level histogram, showing a radiological improvement (Figure 1). However, there are some limitations in the use of plain radiographs and MVGLH and EGLH, especially in the case of the thorax and the abdomen where there are superimposed movable tissues. The deviation in MVGLH was studied after sequential radiographs were taken using the same settings and it was found to be higher in areas of the thorax (21.2%) and the abdomen (42.4%), while the deviation in weight-bearing bones was a maximum of 2.9% [24]. The use of an image-processing method that could offer quality assurance and reproducibility, by means of CT images that are used for solid organs, seems appealing.


Bone Density as a Marker of Response to Radiotherapy in Bone Metastatic Lesions: A Review of the Published Data
First-order statistics as an image processing technique for the evaluation of recalcification of bone lytic metastasis at the femur after radiotherapy. Mean value and energy (MVGLH, EGLH) at baseline (EGLH = 0.19, MVGLH = 155.1) and six months after initiation of multimodality treatment (EGLH = 0.17, MVGLH = 173.3). P(I) refers to the probability of intensity (I).
© Copyright Policy
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC5037671&req=5

ijms-17-01391-f001: First-order statistics as an image processing technique for the evaluation of recalcification of bone lytic metastasis at the femur after radiotherapy. Mean value and energy (MVGLH, EGLH) at baseline (EGLH = 0.19, MVGLH = 155.1) and six months after initiation of multimodality treatment (EGLH = 0.17, MVGLH = 173.3). P(I) refers to the probability of intensity (I).
Mentions: As mineral is lost from the lytic metastases, the distribution of pixel intensities is shifted and becomes more concentrated at the lower gray levels. As a result, the mean value decreases and the energy increases in the osteolytic regions. After the evaluation of the images by expert radiologists, significant changes were detected. In detail, there was an 11.08% (95% CI 10.21, 11.93) mean reduction of energy in the gray-level histogram and an 11.63% (95% CI 10.96, 12.29) increase in the mean value of the gray-level histogram, showing a radiological improvement (Figure 1). However, there are some limitations in the use of plain radiographs and MVGLH and EGLH, especially in the case of the thorax and the abdomen where there are superimposed movable tissues. The deviation in MVGLH was studied after sequential radiographs were taken using the same settings and it was found to be higher in areas of the thorax (21.2%) and the abdomen (42.4%), while the deviation in weight-bearing bones was a maximum of 2.9% [24]. The use of an image-processing method that could offer quality assurance and reproducibility, by means of CT images that are used for solid organs, seems appealing.

View Article: PubMed Central - PubMed

ABSTRACT

Metastases to the bone are presenting in a great percentage of patients with cancer, causing a variety of symptoms, affecting the quality of life and survival of patients. A multidisciplinary approach from different health providers is required for treatment, including radiation oncologists, medical oncologists and surgeons. The role of radiotherapy in the management of bone metastases has long been established through multiple randomized trials. The estimation of response to the therapy is subjective and is based on the palliation of the symptoms that the patients report. However, a quantification of the tumor burden and response to the treatment with the use of an objective method to measure those parameters is a clinical expectation in oncology. The change in bone density in affected areas (mainly lytic) after local radiotherapy, representing the cellular changes that have occurred, is a promising marker of response to treatment.

No MeSH data available.


Related in: MedlinePlus