Reginelli Alfonso, Patanè Vittorio, Urraro Fabrizio, Russo Anna, De Chiara Marco, Clemente Alfredo, Atripaldi Umberto, Balestrucci Giovanni, Buono Mauro, D'ippolito Emma, Grassi Roberta, D'onofrio Ida, Napolitano Stefania, Troiani Teresa, De Vita Ferdinando, Ciardiello Fortunato, Nardone Valerio, Cappabianca Salvatore
Department of Precision Medicine, University of Campania "L. Vanvitelli", 80138 Naples, Italy.
Diagnostics (Basel). 2023 Jul 10;13(14):2334. doi: 10.3390/diagnostics13142334.
Metastasis to bone is a common occurrence among epithelial tumors, with a high incidence rate in the Western world. As a result, bone lesions are a significant burden on the healthcare system, with a high morbidity index. These injuries are often symptomatic and can lead to functional limitations, which in turn cause reduced mobility in patients. Additionally, they can lead to secondary complications such as pathological fractures, spinal cord compression, hypercalcemia, or bone marrow suppression. The treatment of bone metastases requires collaboration between multiple healthcare professionals, including oncologists, orthopedists, neurosurgeons, physiatrists, and radiotherapists. The primary objective of this study is to evaluate the correlation between two methods used to assess local control. Specifically, the study aims to determine if a reduction in the volume of bone lesions corresponds to better symptomatic control in the clinical management of patients, and vice versa. To achieve this objective, the study evaluates morphological criteria by comparing pre- and post-radiotherapy treatment imaging using MRI and RECIST 1.1 criteria. MRI without contrast is the preferred diagnostic imaging method, due to its excellent tolerance by patients, the absence of exposure to ionizing radiation, and the avoidance of paramagnetic contrast media side effects. This imaging modality allows for accurate assessment of bone lesions. One of the secondary objectives of this study is to identify potentially useful parameters that can distinguish patients into two classes: "good" and "poor" responders to treatment, as reported by previous studies in the literature. These parameters can be evaluated from the imaging examinations by analyzing morphological changes and radiomic features on different sequences, such as T1, STIR (short tau inversion recovery), and DWI-MRI (diffusion-weighted).
骨转移是上皮性肿瘤中的常见现象，在西方世界发病率很高。因此，骨病变给医疗系统带来了沉重负担，发病率很高。这些损伤通常有症状，会导致功能受限，进而使患者活动能力下降。此外，它们还会引发继发性并发症，如病理性骨折、脊髓压迫、高钙血症或骨髓抑制。骨转移的治疗需要包括肿瘤学家、骨科医生、神经外科医生、物理治疗师和放射治疗师在内的多个医疗专业人员的协作。本研究的主要目的是评估两种用于评估局部控制的方法之间的相关性。具体而言，该研究旨在确定在患者的临床管理中，骨病变体积的减小是否对应更好的症状控制，反之亦然。为实现这一目标，该研究通过使用MRI和RECIST 1.1标准比较放疗前后的影像学检查来评估形态学标准。无对比剂的MRI是首选的诊断成像方法，因为它对患者耐受性好，不存在电离辐射暴露，且避免了顺磁性对比剂的副作用。这种成像方式能够准确评估骨病变。本研究的次要目标之一是识别潜在有用的参数，这些参数可以将患者分为两类：如文献中先前研究报道的对治疗“反应良好”和“反应不佳”的患者。这些参数可以通过分析不同序列（如T1、短tau反转恢复序列（STIR）和扩散加权成像（DWI-MRI））上的形态学变化和放射组学特征，从影像学检查中进行评估。
