99mTc MDP SPECT-CT–Based Modified Mirels Classification for Evaluation of Risk of Fracture in Skeletal Metastasis

Riaz, Saira; Bashir, Humayun; Niazi, Imran Khalid; Butt, Sumera; Qamar, Faisal

doi:10.1097/rlu.0000000000002057

Cited by 4 publications

(3 citation statements)

References 5 publications

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“…Direct comparison with Mirels criteria shows superior specificity, positive predictive value, and accuracy while maintaining very high sensitivity and negative predictive value ( 6 - 8 , 21 ). Other new techniques, including SPECT-CT, FDG-PET, and machine learning are developing on the horizon ( 22 - 24 ).…”

Section: Discussionmentioning

confidence: 99%

Prophylactic surgical treatment using CT-based rigidity analysis vs. after the fact fracture treatment of pathologic femoral lesions

DeHority¹,

Craig²,

Damron³

2022

Ann Joint

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Background Accurate comparison of prophylactic surgical treatment (PST) to after fracture treatment (AF) of patients with femoral metastatic disease requires more accurately identifying patients for impending fracture, such as with CT-based structural rigidity analysis (CTRA). This study compares a more accurately defined PST group (of impending fractures defined by CTRA) to AF for metastatic femoral disease. Methods PST patients were enrolled and treated by the PI in a longitudinal multicenter study of impending pathologic fractures evaluated for accuracy by CTRA. The AF patients were also treated by the senior author and were identified by retrospective chart review. Fifty-five patients were treated surgically for metastatic femoral lesions and were divided into three groups for the purpose of this study: Group I (AF), Group II (PST-high), and Group III (PST-low). Demographic information, comorbidities, and clinical variables of interest were collected by retrospective chart review; cost data was collected by collaboration with our hospital financial personnel (office of the Chief Financial Officer). Results Survival showed statistically significant differences favoring Group II. Transfusions in Group I were nearly twice those of Groups II and III, but there was no statistically significant (NS) difference between groups. Estimated blood loss (EBL) was generally with NS difference. Similarly, there were NS differences in LOS between groups. Discharge disposition showed statistically significant differences between groups (P=0.012, global). Discharge to home was highest in Group II (76%) and lowest in Group I (27%). Discharge to rehab was lowest in Group II (24%) and highest in Group I (47%). There were no discharges to hospice or morgue in Group II, while both occurred in Group I. Mean direct and total costs were highest in Group I ($18,837 and $31,997, respectively) and lowest in Group II ($16,094 and $27,357) but the differences were NS. Conclusions This study shows benefits of PST over AF in a group of PST patients more accurately defined to have impending pathologic fractures by CTRA definition.

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Section: Discussionmentioning

confidence: 99%

Prophylactic surgical treatment using CT-based rigidity analysis vs. after the fact fracture treatment of pathologic femoral lesions

DeHority¹,

Craig²,

Damron³

2022

Ann Joint

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“…the evaluation system has a good sensitivity (91%) but a relatively low specificity (35%). 57 Mirels criteria can be used as an aid in selecting suitable participants for the exercise prescription too (table iV). 57,58 Other fracture screening tools can be useful, as the screening tool of the World Health Organization Fracture risk assessment (FraX), 59 which identifies the 10-year fracture risk.…”

Section: Discussionmentioning

confidence: 99%

“…57 Mirels criteria can be used as an aid in selecting suitable participants for the exercise prescription too (table iV). 57,58 Other fracture screening tools can be useful, as the screening tool of the World Health Organization Fracture risk assessment (FraX), 59 which identifies the 10-year fracture risk. This last tool is considered superior to the use of bone mineral density measures alone to determine the risk of fractures.…”

Section: Discussionmentioning

confidence: 99%

Exercise therapy indications in metastatic bone patients

Colò

Massarini

Cavagnaro³

et al. 2020

Minerva Ortop Traumatol

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INTRODUCTION: In recent years, the exercise prescription has given unequivocal benefits in cancer patients. The purpose of this review is to analyze indications of exercise therapy in the patient with bone metastases, analyzing the benefits, limits and appropriate indications of physical activity according to the individual clinical situation of the patient. eVideNce acQuiSitiON: the present systematic review was conducted using a thorough database search of pubMed, EMBASE and SCOPUS. Authors independently screened all articles identified concerning exercise therapy in metastatic bone patients, to assess their suitability to the research focus. eVideNce SYNtHeSiS: authors included 12 articles as full-text in 19 papers, dated from 2000 to 2018. among these, 8 were randomized controlled trials, 3 single-arm studies and 1 multi-arm interventional study. aerobic and/or resistance exercise training was prescribed in all the studies analyzed. the mean follow-up was 10.7±11.2 (range 1-36) months. Significant benefits were reported in fatigue, pain and physical function with no increasing incidence of pathologic fractures. cONcluSiONS: exercise therapy in patients with bone metastases is useful in tackling bone loss, showing anticancer effects and increasing patient's quality of life with very low adverse effects rate (2,2%). the prescription of exercises in this kind of patients can be complex for the possible increasing risk of pathological fractures and pain levels. it is therefore strictly necessary to personalize the exercises according to patient's abilities, skeletal site and type of metastatic lesion.

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CORR Insights®: Is There an Association Between Prophylactic Femur Stabilization and Survival in Patients with Metastatic Bone Disease?

Damron

2019

Clin Orthop Relat Res

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99mTc MDP SPECT-CT–Based Modified Mirels Classification for Evaluation of Risk of Fracture in Skeletal Metastasis

Cited by 4 publications

References 5 publications

Prophylactic surgical treatment using CT-based rigidity analysis vs. after the fact fracture treatment of pathologic femoral lesions

Prophylactic surgical treatment using CT-based rigidity analysis vs. after the fact fracture treatment of pathologic femoral lesions

Exercise therapy indications in metastatic bone patients

CORR Insights®: Is There an Association Between Prophylactic Femur Stabilization and Survival in Patients with Metastatic Bone Disease?

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