The effects of metastatic lesion on the structural determinants of bone: Current clinical and experimental approaches.
Bone quality
Engineering analysis
Fracture prediction
Image-based
Journal
Bone
ISSN: 1873-2763
Titre abrégé: Bone
Pays: United States
ID NLM: 8504048
Informations de publication
Date de publication:
09 2020
09 2020
Historique:
received:
05
08
2019
revised:
31
10
2019
accepted:
18
11
2019
pubmed:
24
11
2019
medline:
22
6
2021
entrez:
24
11
2019
Statut:
ppublish
Résumé
Metastatic bone disease is incurable with an associated increase in skeletal-related events, particularly a 17-50% risk of pathologic fractures. Current surgical and oncological treatments are palliative, do not reduce overall mortality, and therefore optimal management of adults at risk of pathologic fractures presents an unmet medical need. Plain radiography lacks specificity and may result in unnecessary prophylactic fixation. Radionuclide imaging techniques primarily supply information on the metabolic activity of the tumor or the bone itself. Magnetic resonance imaging and computed tomography provide excellent anatomical and structural information but do not quantitatively assess bone matrix. Research has now shifted to developing unbiased data-driven tools that can predict risk of impending fractures and guide individualized treatment decisions. This review discusses the state-of-the-art in clinical and experimental approaches for prediction of pathologic fractures with bone metastases. Alterations in bone matrix quality are associated with an age-related increase in skeletal fragility but the impact of metastases on the intrinsic material properties of bone is unclear. Engineering-based analyses are non-invasive with the capability to evaluate oncological treatments and predict failure due to the progression of metastasis. The combination of these approaches may improve our understanding of the underlying deterioration in mechanical performance.
Identifiants
pubmed: 31759204
pii: S8756-3282(19)30453-3
doi: 10.1016/j.bone.2019.115159
pmc: PMC7531290
mid: NIHMS1612518
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
115159Subventions
Organisme : NIAMS NIH HHS
ID : R01 AR075964
Pays : United States
Organisme : NIAMS NIH HHS
ID : R21 AR066916
Pays : United States
Organisme : NIAMS NIH HHS
ID : R56 AR075964
Pays : United States
Organisme : NCI NIH HHS
ID : T32 CA225617
Pays : United States
Informations de copyright
Copyright © 2019 Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of competing interest The authors declare that they have no conflict of interest.
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