CT hounsfield unit and histogram analysis for differentiation of recent versus remote vertebral compression fractures

2021 ◽  
pp. 20210941
Author(s):  
Chang Hyun Ryoo ◽  
Jee Won Chai ◽  
Sung Hwan Hong ◽  
Ja-Young Choi ◽  
Hye Jin Yoo ◽  
...  
Keyword(s):  
Trabecular Bone ◽  
Area Under The Curve ◽  
Hounsfield Unit ◽  
Histogram Analysis ◽  
Vertebral Compression Fractures ◽  
Roc Curve Analysis ◽  
Compression Fractures ◽  
High Area ◽  
Tissue Changes ◽  
Vertebral Bodies

Objectives: The purpose of this study was to analyze the intraosseous tissue changes in recent vertebral compression fractures (VCFs) and to differentiate recent from remote VCFs using CT Hounsfield unit histogram analysis (HUHA). Methods: Sixty-five patients with T11 to L3 VCFs were included. HUHA of 2 vertebral bodies (VBs)— a fractured VB and the closest lower-level unaffected VB—was done. The mean Hounsfield unit (HU) value and HU proportions of 5 ranges (HU ≤ 0, 0 < HU≤50, 50 < HU≤100, 100 < HU≤150, and HU > 150) were obtained. Then, ΔHU value and ΔHU proportion were calculated by subtracting the values from the two vertebrae. Finally, the obtained values were compared between the recent and remote VCF groups and subjected to ROC curve analysis. Results: In recent VCF group, the ΔHU proportion (HU ≤0) corresponding to normal fatty marrow was lower (-0.17 vs 0.01) and the ΔHU proportion (HU >150) representing trabecular bone was higher (0.23 vs 0.04) than in remote VCF group (p < 0.001). In the differentiation of recent from remote VCF, the ΔHU value and ΔHU proportion (HU >150) showed high area under the curve (AUC, 0.939 and 0.912, respectively). Conclusions: CT HUHA demonstrated both trabecular bone and bone marrow changes in recent VCFs, and showed high diagnostic performance in differentiating between recent and remote VCFs. Advances in knowledge: With its vendor neutral applicability, CT HUHA can be used for the differentiation of recent and remote VCFs.

scholarly journals Impact of Feature Selection on Clustering Images ofVertebral Compression Fractures

2020 ◽  
Author(s):  
Raquel Candido ◽  
Rafael Lama ◽  
Natália Chiari ◽  
Marcello Nogueira-Barbosa ◽  
Paulo Azevedo Marques ◽  
...  
Keyword(s):  
Feature Selection ◽  
Metastatic Cancer ◽  
Vertebral Compression Fractures ◽  
Features Selection ◽  
Correct Classification ◽  
Compression Fractures ◽  
Vertebral Bodies ◽  
The Impact ◽  
Aided Diagnosis

Non-traumatic Vertebral Compression Fractures (VCFs) are generally caused by osteoporosis (benign VCFs) or metastatic cancer (malignant VCFs) and the success of the medical treatment strongly depends on a fast and correct classification of VCFs. Recently, methods for computer-aided diagnosis (CAD) based on machine learning have been proposed for classifying VCFs. In this work, we investigate the problem of clustering images of VCFs and the impact of feature selection by genetic algorithms, comparing the clustering i)with all features and ii)with feature selection through the purity results. The analysis of the clusters helps to understand the results of classifiers and difficulties of differentiating images of different classes by an expert. The results indicate that features selection improved the separability of clusters and purity. Feature selection also helps to understand which attributes are most important for analysing the images of vertebral bodies.

Preoperative chemoradiotherapy for pancreatic cancer encountered vertebral compression fractures.

2013 ◽  
Vol 31 (4_suppl) ◽  
pp. 227-227
Author(s):  
Keisuke Otani ◽  
Teruki Teshima ◽  
Kinji Nishiyama ◽  
Yuri Ito ◽  
Yoshifumi Kawaguchi ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
De Novo ◽  
Preoperative Chemoradiotherapy ◽  
Incidence Rates ◽  
Mesenteric Arteries ◽  
Vertebral Compression Fractures ◽  
Resectable Pancreatic Cancer ◽  
Compression Fractures ◽  
Dose Volume ◽  
Vertebral Bodies

227 Background: Preoperative chemoradiotherapy (CRT) with gemcitabine (GEM) for pancreatic cancer at our institute achieved excellent cure rates, while treated patients encountered vertebral compression fractures (VCFs) frequently. Methods: From January 2006 to December 2011, 220 patients (male/female: 134/86, median age: 66 (range: 33-84)) with resectable pancreatic cancer have been treated with preoperative CRT with GEM. This method consisted of concurrent radiotherapy (50-60 Gy in 25 fractions over 5 weeks) and chemotherapy (GEM 1,000 mg/m2intravenous, weekly for 12-15 weeks, 3 times during 4 weeks). Three-dimensional conformal radiotherapy was used and its fields covered both primary pancreatic tumor and retropancreatic tissues with 50 Gy level. Boost irradiation to the roots of celiac and superior mesenteric arteries with 2.4 Gy/fr using field-within-field technique has been started since 2009. The risk factors for VCF and its causes were retrospectively analyzed for 1,308 Th10-L3 vertebral bodies. Results: Follow-up time from the initiation of CRT ranged from 3.4-73.9 months (median: 17.9). Median overall survival time of these patients was 40.6 months. Radical surgery was completed in 164 patients (75%). Twenty-five patients (11%) diagnosed as VCF (CTCAE v4.0 grade1/2: 12/13) and 22 of them were at 3.6-23 months from CRT. Cumulative incidence rates at 2 years were 18.9% in total, 8.5% in male and 38.4% in female (p = 0.0002). Corresponding rates were 5.1% in age < 60 and 24.9% in age ≥ 60 (p = 0.0107). On their courses 37 de novo VCFs (Th10/11/12/L1/2/3: 2/3/11/13/7/1) were observed at first and 9 patients repeated VCFs near the initial VCFs. Dose-volume factors of each vertebral bodies also significantly correlated with VCF; vertebrae whose mean dose were < 38 Gy/ ≥ 38 Gy developed VCFs in 2.7%/10.0% at 2 years (p < 0.0001), vertebrae whose V30 were < 80%/≥80% developed VCFs in 2.4%/10.6% (p < 0.0001). Conclusions: Besides women and higher age, dose-volume factors of radiotherapy were risk of developing VCF in patients with pancreatic cancer after preoperative CRT with GEM. These findings should be considered to avoid VCFs as late adverse event after CRT for pancreatic cancer, especially in IMRT era.

scholarly journals Conservative treatment of children with vertebral compression fractures of the thoracic and lumbar spine in the Russian Federation: a literature review

2016 ◽  
Vol 4 (1) ◽  
pp. 48-56 ◽  
Author(s):  
Alexei G Baindurashvili ◽  
Sergei V Vissarionov ◽  
Ivan V Pavlov ◽  
Dmitriy N Kokushin ◽  
Grigoriy A Lein
Keyword(s):  
Lumbar Spine ◽  
Selection Criteria ◽  
Vertebral Compression Fractures ◽  
Orthotic Devices ◽  
Literature Analysis ◽  
Spinal Segment ◽  
Compression Fractures ◽  
Thoracic And Lumbar Spine ◽  
Vertebral Bodies ◽  
The Russian Federation

Various options for medical treatment of children with compression fractures of the thoracic and lumbar spine include unloading of damaged segments by simultaneous or gradual reclination (e.g., functional traction and reclination of the spine); measures aimed at building and strengthening the muscular “corset” of the back; and the use of orthotic devices of various designs (e.g., fixating-discharging, fixating-correcting corsets, orthoses on a modular basis). Questions regarding the early and late use of orthotics in patients with compression fractures of the vertebral bodies are discussed. Literature analysis, considering different methods used in the treatment of these patients in terms of their effectiveness to restore the height and shape of the damaged spinal segment revealed the absence of a differentiated approach for choosing treatment and selection criteria for orthopedic management.

scholarly journals Prophylactic Percutaneous Kyphoplasty Treatment for Nonfractured Vertebral Bodies in Thoracolumbar for Osteoporotic Patients

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Fei Lei ◽  
Wen He ◽  
Xinggui Tian ◽  
Zhongyang Li ◽  
Lipeng Zheng ◽  
...  
Keyword(s):  
Vertebral Compression Fractures ◽  
Compression Fractures ◽  
Percutaneous Kyphoplasty ◽  
Significant Difference ◽  
Thoracolumbar Region ◽  
Vas Scores ◽  
Vertebral Bodies ◽  
The Mean ◽  
One Year

Purpose. The occurrence of new vertebral compression fractures (VCFs) is a common complication after percutaneous kyphoplasty (PKP). Secondary VCFs after PKP occur predominantly in the thoracolumbar segment (T11 to L2). Prophylactic injections of cement into vertebral bodies in order to reduce new VCFs have rarely been reported. The main purpose of this study was to investigate whether prophylactically injecting cement into a nonfractured vertebral body at the thoracolumbar level (T11-L2) could reduce the occurrence of new VCFs. Methods. From July 2011 to July 2018, PKP was performed in 86 consecutive patients with osteoporotic vertebral compression fractures (OVCFs) in the thoracolumbar region (T11-L2). All patients selected underwent PKP because of existing OVCFs (nonprophylactic group). Additionally, 78 consecutive patients with fractured vertebrae in the thoracolumbar region (T11-L2) with OVCFs underwent PKP and received prophylactic injections of cement into their nonfractured vertebrae in the thoracolumbar region (T11-L2) (prophylactic group). The visual analog scale (VAS) scores and incidence of new VCFs after PKP were compared between the two groups. Results. The mean VAS scores improved from 8.00±0.79 preoperatively to 1.62±0.56 at the last follow-up in the nonprophylactic group and improved from 8.17±0.84 to 1.76±0.34 in the prophylactic group (P>0.05). In the nonprophylactic group, 21 of 86 patients (24.4%) developed new VCFs within one year after PKP, of whom 15 patients (71.4%) developed VCFs within 3 months. In the prophylactic group, 8 of 78 patients (10.3%) developed new VCFs within one year, and 6 of these 8 patients (75%) developed new VCFs within 3 months. The incidence of new VCFs was significantly higher in the nonprophylactic group than that in the prophylactic group at one year (P=0.018), but there were no statistically significant differences at three months (P=0.847). Conclusions. Prophylactic injections of cement into nonfractured (T11-L2) vertebral bodies reduced the incidence of secondary VCFs after PKP in patients with OVCFs, but there was no significant difference in local back pain (VAS) scores between the two groups.

scholarly journals Height and Volume Restoration In Osteoporotic Vertebral Compression Fractures: A Biomechanical Comparison Of Standard Balloon Kyphoplasty Versus Tektona In A Cadaveric Fracture Model

2020 ◽  
Author(s):  
Antonio Krüger ◽  
Martin Bäumlein ◽  
Tom Knauf ◽  
Hugues Pascal-Moussellard ◽  
Steffen Ruchholtz ◽  
...  
Keyword(s):  
Vertebral Body ◽  
Balloon Kyphoplasty ◽  
Ct Scans ◽  
Matched Pair ◽  
Vertebral Compression Fractures ◽  
Osteoporotic Vertebral Compression Fractures ◽  
Compression Fractures ◽  
Before And After ◽  
Vertebral Bodies ◽  
The Difference

Abstract Background: Standard balloon kyphoplasty represents a well-established treatment option for osteoporotic vertebral compression fractures. Aim of the present study was to evaluate two different methods of percutaneous augmentation (standard Balloon kyphoplasty (BKP) versus Tektona (TEK)) with respect to height restoration. Methods: Four-teen vertebral bodies of two female cadavers were examined. Fractures were created using a standardized protocol. CT-scans were taken before and after fracture, as well as after treatment. Afterwards two groups were randomly assigned in a matched pair design: 7 vertebral bodies (VB) were treated with (BKP, Kyphon, Medtronic) and 7 vertebral bodies by TEK (Spineart, Switzerland) Anterior, central and posterior vertebral body heights were evaluated by CT-scans. Volumetry was performed using the CT-scans at three different timepoints. Results: Values before fracture represent 100 %. The anterior height after fracture was reduced to 75,99 (± 4,8) % for the BKP group and to 76,54 (± 9,17) % in the TEK Group. Statistically there was no difference for the groups (p = 1). After treatment the values increased to 93,06 (±5) % for the BKP Group and 87,71 (±6,2) % for the TEK Group. The difference before and after treatment was significant for both groups (BKP p =0,0006; TEK p= 0,03). Within the groups, there was no difference (p=0,13). The Volume of the vertebral body was reduced to 82,29 (±8,4) % in the BKP Group and to 76,54 (±8,6) % in the TEK Group. After treatment the volume was 89,26 (±6,9) % for the BKP Group and 88,80 (±8,7) % for the TEK Group. The difference before and after treatment was significant only for the TEK group (BKP p =0,0728 n.s.; TEK p= 0,0175). Within the groups, there was no difference (p=0,2). The average cement volume used was 6,1 (range 3,6 - 9 ml) for the BKP group and 5,3 (3 - 7,2 ml) for the TEK group respectively.Conclusions: Based on our results the new System Tektona in osteoporotic compression fractures might represent a promising alternative for the clinical setting, especially preserving bone. Further biomechanical tests and clinical studies have to proof Tektona`s capabilities.

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