News Patient-specific computer models can help predicting fracture risk

12 July 2018

Patient-specific computer (finite element (FE)) models are a potential tool to improve clinical fracture risk predictions in patients with metastatic bone disease. That was concluded in a study by Eggermont et al., recently published in Bone and Joint Research.

Patients with cancer and bone metastases have an increased risk of pathological fractures, which severely affect the quality of life. Treatment of patients with bone metastases is based on the fracture risk: patients with a low fracture risk will be treated conservatively with local radiotherapy, while patient with a high fracture risk are considered for preventive stabilizing surgery. However, current clinical practice lacks an accurate tool to guide clinicians to the correct treatment decision. Therefore, researchers from the Orthopaedic Research Lab have been developing an FE model for fracture risk prediction, which was previously validated using cadaveric femurs. The next step was to evaluate the FE models in a multi-center prospective cohort study. A total of 39 patients with non-fractured femoral metastatic lesions who were treated with radiotherapy were included. All patients underwent CT scans, from which the patient-specific geometry and bone density were obtained, that functioned as input to the FE models. An axial load was simulated on the FE models and femoral failure load was calculated. Patients were followed for six months, during which nine pathological fractures occurred. FE-predicted failure loads were compared between fractured and non-fractured femurs. In addition, the FE-predictions were compared with fracture risk assessments by experienced clinicians.The FE model was more accurate at identifying patients with a high fracture risk compared with experienced clinicians, with a sensitivity of 89% versus 0% to 33% for clinical assessments. Specificity was 79% for the FE models versus 84% to 95% for clinical assessments. It was concluded that FE models can be a valuable tool to improve clinical fracture risk predictions in metastatic bone disease, mainly to prevent unnecessary surgeries.

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

Florieke Eggermont is member of research theme Reconstructive and regenerative medicine.

Related news items

Wout Feitz new coordinator EU ERN eUROGEN

19 November 2018

For patients with a rare or complex urogenital disease or condition, eUROGEN is the European Reference Network.

read more

VSB Scholarships for studying or doing research abroad

16 November 2018

For those of you who have supervised or will supervise students who finish their BSc or MSc between 1-3-2018 and 31-12-2019.

read more

EMUC first prize poster on bladder cancer for Alina Vrieling

15 November 2018

Alina Vrieling received the first prize for the best unmoderated poster on Bladder Cancer at the 10th European Multidisciplinary Congress on Urological Cancers (EMUC).

read more

Regenerative medicine could treat fecal incontinence, in the future

15 November 2018

Wiep de Lingy and Alejandra Ruiz-Zapata, theme Reconstructive and regenerative medicine, systematically reviewed preclinical and clinical studies looking into regenerative medicine strategies to treat fecal incontinence in a recent publication in the American Journal of Obstetrics and Gynecology.

read more

Large NWO grant for Chris de Korte

15 November 2018

NWO Domain Applied and Engineering Sciences (AES) has granted project ULTRA-X-TREME 4 million euros for developing new 3D ultrasound techniques allowing patient-specific diagnosis of vascular problems and prevention of unnecessary operations.

read more

A personal touch of Frank Walboomers

15 November 2018

In order to promote interaction amongst colleagues within RIMLS, we have a ‘personal touch’ series setting employees in the spotlight. A light-hearted manner to learn about the colleagues you know and those you don’t! This week: Frank Walboomers.

read more
  • Go to