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Eggermont F, Derikx LC, Verdonschot N, et al. Can patient-specific finite element models better predict fractures in metastatic bone disease than experienced clinicians?: Towards computational modelling in daily clinical practice. Bone Joint Res. 2018;7(6):430-439doi: 10.1302/2046-3758.76.BJR-2017-0325.R2.
Eggermont, F., Derikx, L. C., Verdonschot, N., van der Geest, I. C. M., de Jong, M. A. A., Snyers, A., van der Linden, Y. M., & Tanck, E. (2018). Can patient-specific finite element models better predict fractures in metastatic bone disease than experienced clinicians?: Towards computational modelling in daily clinical practice. Bone & joint research, 7(6), 430-439. https://doi.org/10.1302/2046-3758.76.BJR-2017-0325.R2
Eggermont, F, et al. "Can patient-specific finite element models better predict fractures in metastatic bone disease than experienced clinicians?: Towards computational modelling in daily clinical practice." Bone & joint research vol. 7,6 (2018): 430-439. doi: https://doi.org/10.1302/2046-3758.76.BJR-2017-0325.R2
Eggermont F, Derikx LC, Verdonschot N, van der Geest ICM, de Jong MAA, Snyers A, van der Linden YM, Tanck E. Can patient-specific finite element models better predict fractures in metastatic bone disease than experienced clinicians?: Towards computational modelling in daily clinical practice. Bone Joint Res. 2018 Jul 07;7(6):430-439. doi: 10.1302/2046-3758.76.BJR-2017-0325.R2. eCollection 2018 Jun. PMID: 30034797; PMCID: PMC6035356.
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Bone Joint Res. 2018 Jul 07;7(6):430-439. doi: 10.1302/2046-3758.76.BJR-2017-0325.R2. eCollection 2018 Jun.

Can patient-specific finite element models better predict fractures in metastatic bone disease than experienced clinicians?: Towards computational modelling in daily clinical practice.

Bone & joint research

F Eggermont, L C Derikx, N Verdonschot, I C M van der Geest, M A A de Jong, A Snyers, Y M van der Linden, E Tanck

Affiliations

  1. Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, The Netherlands.
  2. Orthopaedic Research Laboratory, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, The Netherlands and Laboratory of Biomechanical Engineering, Enschede, The Netherlands.
  3. Radiotherapeutic Institute Friesland, Leeuwarden, The Netherlands.
  4. Department of Radiotherapy, Leiden University Medical Center, Leiden, The Netherlands.

PMID: 30034797 PMCID: PMC6035356 DOI: 10.1302/2046-3758.76.BJR-2017-0325.R2

Abstract

OBJECTIVES: In this prospective cohort study, we investigated whether patient-specific finite element (FE) models can identify patients at risk of a pathological femoral fracture resulting from metastatic bone disease, and compared these FE predictions with clinical assessments by experienced clinicians.

METHODS: A total of 39 patients with non-fractured femoral metastatic lesions who were irradiated for pain were included from three radiotherapy institutes. During follow-up, nine pathological fractures occurred in seven patients. Quantitative CT-based FE models were generated for all patients. Femoral failure load was calculated and compared between the fractured and non-fractured femurs. Due to inter-scanner differences, patients were analyzed separately for the three institutes. In addition, the FE-based predictions were compared with fracture risk assessments by experienced clinicians.

RESULTS: In institute 1, median failure load was significantly lower for patients who sustained a fracture than for patients with no fractures. In institutes 2 and 3, the number of patients with a fracture was too low to make a clear distinction. Fracture locations were well predicted by the FE model when compared with post-fracture radiographs. The FE model was more accurate in identifying patients with a high fracture risk compared with experienced clinicians, with a sensitivity of 89%

CONCLUSION: FE models can be a valuable tool to improve clinical fracture risk predictions in metastatic bone disease. Future work in a larger patient population should confirm the higher predictive power of FE models compared with current clinical guidelines.

Keywords: Femur; Finite element modelling; Fracture prediction; Metastatic bone disease

Conflict of interest statement

Conflict of Interest Statement: None declared

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