Relationships between material properties and CT scan data of cortical bone with and without metastatic lesions.
Breast, prostate, lung, and other cancers can metastasize to bone and lead to pathological fracture. To lay the groundwork for new clinical techniques for assessing the risk of pathological fracture, we identified relationships between density measured using quantitative computed tomography (rhoQCT), longitudinal mechanical properties, and ash density (rhoAsh) of cortical bone from femoral diaphyses with and without metastatic lesions from breast, prostate, and lung cancer (bone with metastases from six donors; bone without metastases from one donor with cancer and two donors without cancer). Moderately strong linear relationships between rhoQCT and elastic modulus, strength, and rhoAsh were found for bone with metastases (0.73<r<0.93, P<0.05). After accounting for differences in rhoQCT, the elastic modulus, compressive strength, tensile yield strain, and rhoAsh of bone with metastatic lesions differed from those of bone from donors without cancer (P<0.01). However, differences in tensile strength or compressive yield strain, after controlling for rhoQCT, were not found. Thus, these cancers degrade the elastic modulus and compressive strength, but not the tensile strength, of cortical bone beyond the amount that would be expected from decreased density alone. The rhoQCT-mechanical property relationships reported may be useful for evaluating bone integrity and assessing the risk of fracture of bone with metastases.
Kaneko
Tadashi S
TS
Department of Orthopaedic Surgery, University of California, Irvine, CA 92697, USA.
Pejcic
Marina R
MR
Tehranzadeh
Jamshid
J
Keyak
Joyce H
JH
D000368:Aged; D015519:Bone Density; D001859:Bone Neoplasms / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000503:physiopathology* / Q000556:secondary; D001943:Breast Neoplasms / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000503:physiopathology; D002102:Cadaver; D019245:Compressive Strength; D004548:Elasticity; D005260:Female; D005264:Femoral Fractures / Q000209:etiology / Q000503:physiopathology; D005269:Femur / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D066298:In Vitro Techniques; D008175:Lung Neoplasms / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000503:physiopathology; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods*; D012680:Sensitivity and Specificity; D013223:Statistics as Topic; D013718:Tensile Strength; D014057:Tomography, X-Ray Computed / Q000379:methods*