Treatment response using CT-based rigidity analysis in an animal model of lytic musculoskeletal lesions subjected to systemic therapy
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Cancer is a global epidemic; over 1.5 million new cancer diagnoses and greater than 600,000 deaths due to cancer are estimated to occur in the United States within the year 2015 alone. Approximately two-thirds of patients with bone metastases will experience pain, pathological fractures, spinal cord or nerve root compression, paralysis, impaired mobility, bone marrow infiltration and hypercalcemia of malignancy. We induced bone metastases through inoculation of rat femurs with MDA-MB-231 human breast cancer cells in order to compare the effectiveness of various treatment modalities, disease progression and recovery through the use of imaging methods in current clinical practice. CTRA provides highly accurate monitoring of metastases progression and treatment through both Ibandronate and Paclitaxel therapies. Using computed tomography (QCT)-based analysis to calculate the load bearing capacity of bone infiltrated with metastatic breast carcinoma, fracture risk threshold was predicted using Computed Topography Rigidity Analysis (CTRA) with 100% sensitivity and 90% specificity. The results of this study further validate that there is an existing gap between clinical guidelines and physician’s recommendations. This inconsistency necessitates that the decision making process for the selection of surgical or non-surgical treatment must be narrowed by more advanced prognostic tools such as CTRA.