title: Validation of DWI in assessment of radiotreated bone metastases in elderly patients.
abstract: Bone metastases are commonly observed in oncologic patients with advanced disease. These metastases are considered the main cause of neoplastic pain, with more than half of oncologic patients experiencing neoplastic pain during the course of the disease due to bone involvement. Lung, breast, and prostate cancers are the primary causes of bone metastases. Magnetic resonance imaging (MRI), especially diffusion weighted imaging (DWI) sequences, is the focus of our research, as it has been proven to be an optimal predictive index to assess the radiation treatment in many patients. We included patients treated with standard fractioning of radiation therapy. First, we examined the irradiated lesions with the MRI-DWI technique, before treatment and 30 and 60 days after its completion. Then we combined the MRI results and clinical parameters in a table with a predictive score for the quality of life in patients with bone metastases. This was a significant predictor of the efficacy of radiation treatment, from both clinical and psychological points of view, as it can allow an early assessment of the response to RT and therefore better scheduling of the next therapeutic steps to be performed. The table of the score we proposed helped guide patient monitoring, enabling us to undertake, where possible, follow-up with therapeutic strategies tailored to each patient's needs.
authors.affiliation: Department of Internal and Experimental Medicine, Magrassi-Lanzara, Institute of Radiology and Radiotherapy, Second University of Naples, Naples, Italy. Electronic address: alfonso.reginelli@unina2.it.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Reginelli
authors.affiliation: Department of Radiotherapy, Cardinale Ascalesi Hospital, Naples, Italy. Electronic address: radioterapia@aslnapoli1centro.it.
authors.forename: Giustino
authors.initials: G
authors.lastname: Silvestro
authors.affiliation: Department of Internal and Experimental Medicine, Magrassi-Lanzara, Institute of Radiology and Radiotherapy, Second University of Naples, Naples, Italy. Electronic address: giovanni.fontanella@hotmail.com.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Fontanella
authors.affiliation: Department of Internal and Experimental Medicine, Magrassi-Lanzara, Institute of Radiology and Radiotherapy, Second University of Naples, Naples, Italy. Electronic address: angsangiova@gmail.com.
authors.forename: Angelo
authors.initials: A
authors.lastname: Sangiovanni
authors.affiliation: Department of Internal and Experimental Medicine, Magrassi-Lanzara, Institute of Radiology and Radiotherapy, Second University of Naples, Naples, Italy. Electronic address: mario.conte@gmail.com.
authors.forename: Mario
authors.initials: M
authors.lastname: Conte
authors.affiliation: Department of Internal and Experimental Medicine, Magrassi-Lanzara, Institute of Radiology and Radiotherapy, Second University of Naples, Naples, Italy. Electronic address: iolandanuzzo@gmail.com.
authors.forename: Iolanda
authors.initials: I
authors.lastname: Nuzzo
authors.affiliation: Department of Radiotherapy, Cardinale Ascalesi Hospital, Naples, Italy. Electronic address: antocalv@libero.it.
authors.forename: Mariagrazia
authors.initials: M
authors.lastname: Calvanese
authors.affiliation: Department of Internal and Experimental Medicine, Magrassi-Lanzara, Institute of Radiology and Radiotherapy, Second University of Naples, Naples, Italy. Electronic address: mtraettino@libero.it.
authors.forename: Marianna
authors.initials: M
authors.lastname: Traettino
authors.affiliation: Department of Internal and Experimental Medicine, Magrassi-Lanzara, Institute of Radiology and Radiotherapy, Second University of Naples, Naples, Italy. Electronic address: pferraioli@hotmail.it.
authors.forename: Piera
authors.initials: P
authors.lastname: Ferraioli
authors.affiliation: Department of Radiotherapy, University of Sassari, Sassari, Italy. Electronic address: robertagrassi@libero.it.
authors.forename: Roberta
authors.initials: R
authors.lastname: Grassi
authors.affiliation: Department of Radiotherapy, Cardinale Ascalesi Hospital, Naples, Italy. Electronic address: radioterapia@aslnapoli1centro.it.
authors.forename: Roberto
authors.initials: R
authors.lastname: Manzo
authors.affiliation: Department of Internal and Experimental Medicine, Magrassi-Lanzara, Institute of Radiology and Radiotherapy, Second University of Naples, Naples, Italy. Electronic address: salvatore.cappabianca@unina2.it.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Cappabianca
mesh_terms: D000368:Aged; D001859:Bone Neoplasms / Q000000981:diagnostic imaging* / Q000532:radiotherapy / Q000556:secondary*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged
keywords: DWI; MRI; MRI-DWI; Palliative care; Radiotherapy; Secondary disease; Spinal metastases