Dataset Information

Invasion of Adjacent Lumbar Vertebral Body from Renal Pelvis Carcinoma: Associated With Bone Metastasis But Easily Overlooked on Initial CT Scan.

ABSTRACT: BACKGROUND/AIM:We hypothesized that regional tumor growth into L1 and L2 vertebral bodies from renal pelvis carcinoma was linked to the development of bone metastases. MATERIALS AND METHODS:Criteria for the study were: (i) Metastatic renal pelvis carcinoma confirmed via pathology and computed tomographic (CT) scan, (ii) L1 and L2 invasion confirmed from retrospective CT scan review, and (iii) detection of bone metastases using radionuclide images/CT scans. RESULTS:A total of 71 cases were enrolled in the study. Initial L1 and L2 vertebral body invasion. were detected in 45 (63%) patients. As well as L1 and L2 invasion, 32 (71%) had development of bone metastases. All bone lesions were osteolytic. Initial L1 and L2 invasion (p<0.00001) was associated with the development of bone metastasis. CONCLUSION:CT scan can help to detect L1 and L2 vertebral body invasion in patients with renal pelvis carcinoma. Early identification and optimal management of such patients is necessary.

SUBMITTER: Liao TY

PROVIDER: S-EPMC6559887 | biostudies-literature | 2019 May-Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Invasion of Adjacent Lumbar Vertebral Body from Renal Pelvis Carcinoma: Associated With Bone Metastasis But Easily Overlooked on Initial CT Scan.

Liao Tzu-Yao TY Liaw Chuang-Chi CC Tsui Ke-Hung KH Juan Yu-Hsiang YH

In vivo (Athens, Greece) 20190501 3

<h4>Background/aim</h4>We hypothesized that regional tumor growth into L1 and L2 vertebral bodies from renal pelvis carcinoma was linked to the development of bone metastases.<h4>Materials and methods</h4>Criteria for the study were: (i) Metastatic renal pelvis carcinoma confirmed via pathology and computed tomographic (CT) scan, (ii) L1 and L2 invasion confirmed from retrospective CT scan review, and (iii) detection of bone metastases using radionuclide images/CT scans.<h4>Results</h4>A total o ...[more]

PMID: 31028220

Similar Datasets

Project description:We sought to determine if vertebral trabecular attenuation values measured on routine body computed tomography (CT) scans obtained for a variety of unrelated indications can predict future osteoporotic fractures at multiple skeletal sites. For this Health Insurance Portability and Accountability Act (HIPAA)-compliant and Institutional Review Board (IRB)-approved retrospective cohort study, trabecular attenuation of the first lumbar vertebra was measured in 1966 consecutive older adults who underwent chest and/or abdominal CT at a single institution over the course of 1 year. New pathologic fragility fractures that occurred after a patient's CT study date were identified through an electronic health record database query using International Classification of Diseases (ICD)-9 codes for vertebral, hip, and extremity fractures. Univariate and multivariate Cox proportional hazards regression were performed to determine the effect of L1 trabecular attenuation on fracture-free survival. Age at CT, sex, and presence of a prior fragility fracture were included as confounders in multivariate survival analysis. Model discriminative capability was assessed through calculation of an optimism-corrected concordance index. A total of 507 patients (mean age 73.4?±?6.3 years; 277 women, 230 men) were included in the final analysis. The median post-CT follow-up interval was 5.8 years (interquartile range 2.1-11.0 years). Univariate analysis showed that L1 attenuation values ?90 Hounsfield units (HU) are significantly associated with decreased fracture-free survival (p?<?0.001 by log-rank test). After adjusting for age, sex, prior fracture, glucocorticoid use, bisphosphonate use, chronic kidney disease, tobacco use, ethanol abuse, cancer history, and rheumatoid arthritis history, multivariate analysis demonstrated a persistent modest effect of L1 attenuation on fracture-free survival (hazard ratio [HR]?=?0.63 per 10-unit increase; 95% confidence interval [CI] 0.47-0.85). The model concordance index was 0.700. Ten-year probabilities for major osteoporosis-related fractures straddled the treatment threshold for most subcohorts over the observed L1 HU range. In conclusion, for patients undergoing body CT scanning for any indication, L1 vertebral trabecular attenuation is a simple measure that, when ?90?HU, identifies patients with a significant decrease in fracture-free survival. © 2018 American Society for Bone and Mineral Research.

Project description:PurposeTo design and validate a fully automated computer system for the detection and anatomic localization of traumatic thoracic and lumbar vertebral body fractures at computed tomography (CT).Materials and methodsThis retrospective study was HIPAA compliant. Institutional review board approval was obtained, and informed consent was waived. CT examinations in 104 patients (mean age, 34.4 years; range, 14-88 years; 32 women, 72 men), consisting of 94 examinations with positive findings for fractures (59 with vertebral body fractures) and 10 control examinations (without vertebral fractures), were performed. There were 141 thoracic and lumbar vertebral body fractures in the case set. The locations of fractures were marked and classified by a radiologist according to Denis column involvement. The CT data set was divided into training and testing subsets (37 and 67 subsets, respectively) for analysis by means of prototype software for fully automated spinal segmentation and fracture detection. Free-response receiver operating characteristic analysis was performed.ResultsTraining set sensitivity for detection and localization of fractures within each vertebra was 0.82 (28 of 34 findings; 95% confidence interval [CI]: 0.68, 0.90), with a false-positive rate of 2.5 findings per patient. The sensitivity for fracture localization to the correct vertebra was 0.88 (23 of 26 findings; 95% CI: 0.72, 0.96), with a false-positive rate of 1.3. Testing set sensitivity for the detection and localization of fractures within each vertebra was 0.81 (87 of 107 findings; 95% CI: 0.75, 0.87), with a false-positive rate of 2.7. The sensitivity for fracture localization to the correct vertebra was 0.92 (55 of 60 findings; 95% CI: 0.79, 0.94), with a false-positive rate of 1.6. The most common cause of false-positive findings was nutrient foramina (106 of 272 findings [39%]).ConclusionThe fully automated computer system detects and anatomically localizes vertebral body fractures in the thoracic and lumbar spine on CT images with a high sensitivity and a low false-positive rate.

Project description:PurposeOrgan autosegmentation efforts to date have largely been focused on adult populations, due to limited availability of pediatric training data. Pediatric patients may present additional challenges for organ segmentation. This paper describes a dataset of 359 pediatric chest-abdomen-pelvis and abdomen-pelvis Computed Tomography (CT) images with expert contours of up to 29 anatomical organ structures to aid in the evaluation and development of autosegmentation algorithms for pediatric CT imaging.Acquisition and validation methodsThe dataset collection consists of axial CT images in Digital Imaging and Communications in Medicine (DICOM) format of 180 male and 179 female pediatric chest-abdomen-pelvis or abdomen-pelvis exams acquired from one of three CT scanners at Children's Wisconsin. The datasets represent random pediatric cases based upon routine clinical indications. Subjects ranged in age from 5 days to 16 years, with a mean age of 7 years. The CT acquisition, contrast, and reconstruction protocols varied across the scanner models and patients, with specifications available in the DICOM headers. Expert contours were manually labeled for up to 29 organ structures per subject. Not all contours are available for all subjects, due to limited field of view or unreliable contouring due to high noise.Data format and usage notesThe data are available on The Cancer Imaging Archive (TCIA_ (https://www.cancerimagingarchive.net/) under the collection Pediatric-CT-SEG. The axial CT image slices for each subject are available in DICOM format. The expert contours are stored in a single DICOM RTSTRUCT file for each subject. The contour names are listed in Table 2.Potential applicationsThis dataset will enable the evaluation and development of organ autosegmentation algorithms for pediatric populations, which exhibit variations in organ shape and size across age. Automated organ segmentation from CT images has numerous applications including radiation therapy, diagnostic tasks, surgical planning, and patient-specific organ dose estimation.

Project description:In a population-based study, we found that computed tomography (CT)-based bone density and strength measures from the thoracic spine predicted new vertebral fracture as well as measures from the lumbar spine, suggesting that CT scans at either the thorax or abdominal regions are useful to assess vertebral fracture risk.IntroductionPrior studies have shown that computed tomography (CT)-based lumbar bone density and strength measurements predict incident vertebral fracture. This study investigated whether CT-based bone density and strength measurements from the thoracic spine predict incident vertebral fracture and compared the performance of thoracic and lumbar bone measurements to predict incident vertebral fracture.MethodsThis case-control study of community-based men and women (age 74.6 ± 6.6) included 135 cases with incident vertebral fracture at any level and 266 age- and sex-matched controls. We used baseline CT scans to measure integral and trabecular volumetric bone mineral density (vBMD) and vertebral strength (via finite element analysis, FEA) at the T8 and L2 levels. Association between these measurements and vertebral fracture was determined by using conditional logistic regression. Sensitivity and specificity for predicting incident vertebral fracture were determined for lumbar spine and thoracic bone measurements.ResultsBone measurements from T8 and L2 predicted incident vertebral fracture equally well, regardless of fracture location. Specifically, for predicting vertebral fracture at any level, the odds ratio (per 1-SD decrease) for the vBMD and strength measurements at L2 and T8 ranged from 2.0 to 2.7 (p < 0.0001) and 1.8 to 2.8 (p < 0.0001), respectively. Results were similar when predicting fracture only in the thoracic versus the thoracolumbar spine. Lumbar and thoracic spine bone measurements had similar sensitivity and specificity for predicting incident vertebral fracture.ConclusionThese findings indicated that like those from the lumbar spine, CT-based bone density and strength measurements from the thoracic spine may be useful for identifying individuals at high risk for vertebral fracture.

Project description:BackgroundMeasuring the Hounsfield units (HU) of the vertebrae may yield diagnostic information for fracture risk. This study aimed to measure HU of vertebrae in percutaneous kyphoplasty (PKP) patients using computed tomography (CT) imaging to determine the HU measurements threshold for adjacent vertebral fracture and to assess the relationship between HU measurements and the risk of adjacent vertebral fracture.MethodsA retrospective study was conducted on consecutive patients who underwent PKP between January 2019 and October 2021 in the China-Japan Union Hospital of Jilin University. The HU of the vertebra was measured on the reconstructed CT images by 2 independent spine surgeons. The HU measurements of adjacent vertebrae and the ratio of HU measurements between the surgical vertebra and adjacent vertebrae were statistically analyzed to determine the best critical value and evaluate the prediction effectiveness and accuracy of the best critical value.ResultsA total of 105 patients were identified with complete imaging and follow-up information. Of these, 47 patients (44.8%) had evidence of an adjacent vertebral fracture on follow-up imaging. The mean HU measurements of the fractured adjacent vertebra were significantly different from the mean HU measurements of the unfractured adjacent vertebra (50.94±20.59 vs. 81.74±18.97 HU; P<0.001). There was a significant difference in the ratio of HU measurements between the surgical vertebra and the fractured adjacent vertebra and between the surgical vertebra and the unfractured adjacent vertebra (26.34±17.52 vs. 14.53±9.40; P<0.001). Interactive scatter plots and receiver operating characteristic (ROC) curve showed that a HU measurement of 66.9 and a HU measurements ratio of 15.18 were the best thresholds for predicting the risk of fracture of adjacent vertebrae after PKP surgery, with an area under the curve (AUC) of 0.901 [95% confidence interval (CI): 0.822-0.953; P<0.001] and 0.874 (95% CI: 0.790-0.934; P<0.001), respectively. The prediction accuracy was 90.4% and 84.0%, respectively.ConclusionsA low mean HU measurements of adjacent vertebrae or a high ratio of the mean HU measurements of the operated vertebrae to the adjacent vertebrae are risk factors for the vulnerability of adjacent vertebrae to fracture. The risk of fracture in the adjacent vertebrae after PKP can be predicted by measuring HU.

Project description:Autogenous iliac crest has long served as the gold standard for anterior lumbar arthrodesis although added morbidity results from the bone graft harvest. Therefore, femoral ring allograft, or cages, have been used to decrease the morbidity of iliac crest bone harvesting. More recently, an experimental study in the animal showed that harvesting local bone from the anterior vertebral body and replacing the void by a radio-opaque beta-tricalcium phosphate plug was a valid concept. However, such a concept precludes theoretically the use of posterior pedicle screw fixation. At one institution a consecutive series of 21 patients underwent single- or multiple-level circumferential lumbar fusion with anterior cages and posterior pedicle screws. All cages were filled with cancellous bone harvested from the adjacent vertebral body, and the vertebral body defect was filled with a beta-tricalcium phosphate plug. The indications for surgery were failed conservative treatment of a lumbar degenerative disc disease or spondylolisthesis. The purpose of this study, therefore, was to report on the surgical technique, operative feasibility, safety, benefits, and drawbacks of this technique with our primary clinical experience. An independent researcher reviewed all data that had been collected prospectively from the onset of the study. The average age of the patients was 39.9 (26-57) years. Bone grafts were successfully harvested from 28 vertebral bodies in all but one patient whose anterior procedure was aborted due to difficulty in freeing the left common iliac vein. This case was converted to a transforaminal interbody fusion (TLIF). There was no major vascular injury. Blood loss of the anterior procedure averaged 250 ml (50-350 ml). One tricalcium phosphate bone plug was broken during its insertion, and one endplate was broken because of wrong surgical technique, which did not affect the final outcome. One patient had a right lumbar plexopathy that was not related to this special technique. There was no retrograde ejaculation, infection or pseudoarthrosis. One patient experienced a deep venous thrombosis. At the last follow up (mean 28 months) all patients had a solid lumbar spine fusion. At the 6-month follow up, the pain as assessed on the visual analog scale (VAS) decreased from 6.9 to 4.5 (33% decrease), and the Oswestry disability index (ODI) reduced from 48.0 to 31.7 with a 34% reduction. However, at 2 years follow up there was a trend for increase in the ODI (35) and VAS (5). The data in this study suggest that harvesting a cylinder of autograft from the adjacent vertebral body is safe and efficient. Filling of the void defect with a beta-tricalcium phosphate plug does not preclude the use of posterior pedicle screw stabilization.

Dataset Information

Invasion of Adjacent Lumbar Vertebral Body from Renal Pelvis Carcinoma: Associated With Bone Metastasis But Easily Overlooked on Initial CT Scan.

Publications

Invasion of Adjacent Lumbar Vertebral Body from Renal Pelvis Carcinoma: Associated With Bone Metastasis But Easily Overlooked on Initial CT Scan.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets