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Li X, Shi X, Wang Y, Pang J, Zhao X, Xu Y, Li Q, Wang N, Duan F, Nie P. A CT-based radiomics nomogram for predicting histologic grade and outcome in chondrosarcoma. Cancer Imaging 2024; 24:50. [PMID: 38605380 PMCID: PMC11007871 DOI: 10.1186/s40644-024-00695-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 03/29/2024] [Indexed: 04/13/2024] Open
Abstract
OBJECTIVE The preoperative identification of tumor grade in chondrosarcoma (CS) is crucial for devising effective treatment strategies and predicting outcomes. The study aims to build and validate a CT-based radiomics nomogram (RN) for the preoperative identification of tumor grade in CS, and to evaluate the correlation between the RN-predicted tumor grade and postoperative outcome. METHODS A total of 196 patients (139 in the training cohort and 57 in the external validation cohort) were derived from three different centers. A clinical model, radiomics signature (RS) and RN (which combines significant clinical factors and RS) were developed and validated to assess their ability to distinguish low-grade from high-grade CS with area under the curve (AUC). Additionally, Kaplan-Meier survival analysis was applied to examine the association between RN-predicted tumor grade and recurrence-free survival (RFS) of CS. The predictive accuracy of the RN was evaluated using Harrell's concordance index (C-index), hazard ratio (HR) and AUC. RESULTS Size, endosteal scalloping and active periostitis were selected to build the clinical model. Three radiomics features, based on CT images, were selected to construct the RS. Both the RN (AUC, 0.842) and RS (AUC, 0.835) were superior to the clinical model (AUC, 0.776) in the validation set (P = 0.003, 0.040, respectively). A correlation between Nomogram score (Nomo-score, derived from RN) and RFS was observed through Kaplan-Meier survival analysis in the training and test cohorts (log-rank P < 0.050). Patients with high Nomo-score tumors were 2.669 times more likely to suffer recurrence than those with low Nomo-score tumors (HR, 2.669, P < 0.001). CONCLUSIONS The CT-based RN performed well in predicting both the histologic grade and outcome of CS.
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Affiliation(s)
- Xiaoli Li
- Department of Radiology, The Affiliated Hospital of Qingdao University, No. 369, Shanghai Road, 266000, Qingdao, Qingdao, Shandong, China
| | - Xianglong Shi
- Department of Radiology, The Affiliated Hospital of Qingdao University, No. 369, Shanghai Road, 266000, Qingdao, Qingdao, Shandong, China
| | - Yanmei Wang
- GE Healthcare China, Pudong New Town, Shanghai, China
| | - Jing Pang
- Department of Radiology, The Affiliated Hospital of Qingdao University, No. 369, Shanghai Road, 266000, Qingdao, Qingdao, Shandong, China
| | - Xia Zhao
- Department of Radiology, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Yuchao Xu
- School of Nuclear Science and Technology, University of South China, Hengyang, Hunan, China
| | - Qiyuan Li
- Department of Radiology, The Affiliated Hospital of Qingdao University, No. 369, Shanghai Road, 266000, Qingdao, Qingdao, Shandong, China
| | - Ning Wang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324, Jingwu Road, 250021, Jinan, Shandong, China.
| | - Feng Duan
- Department of Radiology, The Affiliated Hospital of Qingdao University, No. 369, Shanghai Road, 266000, Qingdao, Qingdao, Shandong, China.
| | - Pei Nie
- Department of Radiology, The Affiliated Hospital of Qingdao University, No. 369, Shanghai Road, 266000, Qingdao, Qingdao, Shandong, China.
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Zhou Y, Li C, Jiang S, Niu F, Cui F, Zhao Y, Wei D, Ma H, Li Y. Diagnosis of SPECT/CT bone imaging combined with two serum examinations in patients with bone metastases from pulmonary cancer. Clin Transl Oncol 2024; 26:147-154. [PMID: 37269491 DOI: 10.1007/s12094-023-03231-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 05/25/2023] [Indexed: 06/05/2023]
Abstract
PURPOSE To study the clinical diagnostic value of SPECT/CT bone imaging combined with two serum examinations in patients with bone metastases from pulmonary cancer. METHODS The clinical data of 120 patients consistent with pulmonary cancer admitted to the First Affiliated Hospital of Hebei North University from March 2019 to December 2019 were selected for retrospective analysis, and they were divided into the bone metastasis group (n = 58) and non-bone metastasis group (n = 62) according to comprehensive evaluation result of X-ray, CT, MRI and clinical follow-up. The CT values of patients were obtained by SPECT/CT bone imaging to compare serum levels of ALP (alkaline phosphatase belongs to phosphoric monoester hydrolases, as a specific phosphatase, mainly in body tissues and body fluid) and BAP (bone alkaline phosphatase is formed by different modification and processing of alkaline phosphatase, and is mainly released by osteoblasts) and CT values of patients in both groups, using receiver operating characteristic (ROC) curve to evaluate the diagnostic efficacy of single detection and combined detection. RESULTS SPECT/CT bone imaging in patients with bone metastasis from pulmonary cancer showed abnormal radioactive accumulation in spine, pelvis and bilateral ribs. Serum ALP, BAP and CT values in bone metastasis group were overtly higher than the non-bone metastasis group (P < 0.001). Logistic regression analysis showed that serum ALP, BAP and CT value were independent risk factors for bone metastasis from pulmonary cancer. The AUC value and Youden index of combined diagnosis were higher than those of single diagnosis. CONCLUSION SPECT/CT bone imaging combined with serum detection of ALP and BAP in patients with pulmonary cancer is helpful for early diagnosis of bone metastasis, which provides more basis for the formulation and selection of clinical treatment options.
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Affiliation(s)
- Yi Zhou
- Department of Nuclear Medicine, The First Affiliated Hospital of Hebei North University, No. 12, Changqing Road, Qiaoxi District, Zhangjiakou, 075000, Hebei, China.
| | - Chuangui Li
- Department of Nuclear Medicine, The First Affiliated Hospital of Hebei North University, No. 12, Changqing Road, Qiaoxi District, Zhangjiakou, 075000, Hebei, China
| | - Shasha Jiang
- Department of Nuclear Medicine, The First Affiliated Hospital of Hebei North University, No. 12, Changqing Road, Qiaoxi District, Zhangjiakou, 075000, Hebei, China
| | - Faliang Niu
- Department of Nuclear Medicine, The First Affiliated Hospital of Hebei North University, No. 12, Changqing Road, Qiaoxi District, Zhangjiakou, 075000, Hebei, China
| | - Feng Cui
- Department of Nuclear Medicine, The First Affiliated Hospital of Hebei North University, No. 12, Changqing Road, Qiaoxi District, Zhangjiakou, 075000, Hebei, China
| | - Yusen Zhao
- Department of Medical Imaging, The First Affiliated Hospital of Hebei North University, Zhangjiakou, 075000, Hebei, China
| | - Dong Wei
- Department of Thoracic Surgery, The First Affiliated Hospital of Hebei North University, Zhangjiakou, 075000, Hebei, China
| | - Hongwei Ma
- Department of Nuclear Medicine, The First Affiliated Hospital of Hebei North University, No. 12, Changqing Road, Qiaoxi District, Zhangjiakou, 075000, Hebei, China
| | - Yan Li
- Department of Nuclear Medicine, The First Affiliated Hospital of Hebei North University, No. 12, Changqing Road, Qiaoxi District, Zhangjiakou, 075000, Hebei, China
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Abstract
Scapular resections are large oncologic undertakings. Due to the soft tissue coverage of the scapula, tumors are often able to be resected with a negative margin. Involvement of the brachial plexus and axillary vessels is rare, allowing for a limb-salvage surgery in most cases. Functional outcomes are based on the magnitude of resection; patients undergoing a partial scapulectomy and those with glenoid preservation demonstrate improved outcomes compared to patients undergoing a total scapulectomy or glenoid resection. Although scapular endoprosthetics are available, there is limited data to support their routine use.
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Affiliation(s)
- Matthew T Houdek
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA.
| | - Benjamin K Wilke
- Department of Orthopedic Surgery, Mayo Clinic, Jacksonville, FL, USA
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Paul M, Sugath BS, P S, Np P, Nair SG, Rajasekharan R. Synchronous Primary Multifocal Skeletal Chondrosarcoma of Extremity: A Report of 2 Cases. JBJS Case Connect 2022; 12:01709767-202203000-00049. [PMID: 35171851 DOI: 10.2106/jbjs.cc.21.00176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
CASE Multifocal synchronous primary skeletal chondrosarcomas of an extremity are rarely reported. In this study, we report 2 such cases. The first case is a 32-year-old woman who presented with extensive right femoral and tibial diaphysis lesions. The second case is a 36-year-old woman with lesions in the left proximal humerus, the coracoid process of scapula and sternum. Both patients underwent limb salvage surgery and were disease-free at the 38- and 20-month follow-up. CONCLUSION Athough rare, the possibility of multifocal chondrosarcoma should be kept in mind during the workup of a patient with chondrosarcoma.
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Affiliation(s)
- Manu Paul
- Department of Surgical oncology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India
| | - Bhaskar Subin Sugath
- Department of Surgical oncology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India
| | - Shivanesan P
- Department of Cardio Vascular and Thoracic Surgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
| | - Prakash Np
- Department of Medical Oncology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India
| | - Sreejith G Nair
- Department of Medical Oncology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India
| | - Rani Rajasekharan
- Department of Pathology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India
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Errani C, Mavrogenis AF, Tsukamoto S. What's new in musculoskeletal oncology. BMC Musculoskelet Disord 2021; 22:704. [PMID: 34404379 PMCID: PMC8369444 DOI: 10.1186/s12891-021-04590-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 08/05/2021] [Indexed: 12/26/2022] Open
Abstract
We reviewed the recent literature related to primary musculoskeletal tumors and metastatic bone tumors. With regard to primary bone tumors, computer navigation systems and three-dimensional-printed prostheses seem to be new treatment options, especially in challenging anatomical locations, such as the sacrum and pelvis. Regarding the treatment of giant cell tumor of bone, recent studies have suggested that denosumab administration is related to a higher local recurrence rate following curettage, but a lower local recurrence rate following en bloc resection. In addition, there was no difference in the local recurrence rate at five years after surgery between short-term and long-term denosumab therapy. With regard to soft tissue tumors, percutaneous cryoablation appears to be a new treatment option for extra-abdominal desmoid tumors, with encouraging results. Regarding soft tissue sarcomas, a negative surgical margin of < 1 mm is sufficient to control local recurrence. Pexidartinib seems to be a promising systemic therapy for the treatment of tenosynovial giant cell tumors for which surgery is not expected to improve the function of the affected limb. Finally, the life expectancy of patients is the most important factor in determining the optimal surgical procedure for patients with impending or pathological fractures of the long bone due to metastatic bone tumors. Elevated C-reactive protein level was found to be an independent poor prognostic factor at 1 year after surgery for long bone metastases.
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Affiliation(s)
- Costantino Errani
- Department of Orthopaedic Oncology, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136, Bologna, Italy.
| | - Andreas F Mavrogenis
- First Department of Orthopedics, School of Medicine, National and Kapodistrian University of Athens, 41 Ventouri Street Holargos, 15562, Athens, Greece
| | - Shinji Tsukamoto
- Department of Orthopaedic Surgery, Nara Medical University, 840, Shijo-cho, Nara, 634-8521, Kashihara-city, Japan
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