Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Mar;47(1):239-248.
doi: 10.1007/s13246-023-01360-2. Epub 2024 Jan 8.

A computed tomography radiomics-based model for predicting osteoporosis after breast cancer treatment

Yu-Hsuan Lai  1   2   3   4 , Yi-Shan Tsai  4   5 , Pei-Fang Su  6 , Chung-I Li  6 , Helen H W Chen  7   8   9
Affiliations

A computed tomography radiomics-based model for predicting osteoporosis after breast cancer treatment

Yu-Hsuan Lai et al. Phys Eng Sci Med. 2024 Mar.

Abstract

Many treatments against breast cancer decrease the level of estrogen in blood, resulting in bone loss, osteoporosis and fragility fractures in breast cancer patients. This retrospective study aimed to evaluate a novel opportunistic screening for cancer treatment-induced bone loss (CTIBL) in breast cancer patients using CT radiomics. Between 2011 and 2021, a total of 412 female breast cancer patients who received treatment and were followed up in our institution, had post-treatment dual-energy X-ray absorptiometry (DXA) examination of the lumbar vertebrae and had post-treatment chest CT scan that encompassed the L1 vertebra, were included in this study. Results indicated that the T-score of L1 vertebra had a strongly positive correlation with the average T-score of L1-L4 vertebrae derived from DXA (r = 0.91, p < 0.05). On multivariable analysis, four clinical variables (age, body weight, menopause status, aromatase inhibitor exposure duration) and three radiomic features extracted from the region of interest of L1 vertebra (original_firstorder_RootMeanSquared, wavelet.HH_glcm_InverseVariance, and wavelet.LL_glcm_MCC) were selected for building predictive models of L1 T-score and bone health. The predictive model combining clinical and radiomic features showed the greatest adjusted R2 value (0.557), sensitivity (83.6%), specificity (74.2%) and total accuracy (79.4%) compared to models that relied solely on clinical data, radiomic features, or Hounsfield units. In conclusion, the clinical-radiomic predictive model may be used as an opportunistic screening tool for early identification of breast cancer survivors at high risk of CTIBL based on non-contrast CT images of the L1 vertebra, thereby facilitating early intervention for osteoporosis.

Keywords: Breast cancer; Cancer treatment-induced bone loss; Computed tomography; Osteoporosis; Predictive modelling; Radiomics.

PubMed Disclaimer

Conflict of interest statement

The authors declare no commercial affiliation, conflict of interest or any potential financial interests involved in this study.

Figures

Fig. 1
Fig. 1
Flow diagram of data processing and analysis
Fig. 2
Fig. 2
Correlation analysis between T-score of L1 vertebra and the average T-score of L1–L4 vertebrae derived from DXA
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Ginsburg O, Bray F, Coleman MP, et al. The global burden of women's cancers: a grand challenge in global health. Lancet. 2017;389:847–860. doi: 10.1016/s0140-6736(16)31392-7. - DOI - PMC - PubMed
    1. Huang YC, Chen YH. Cancer incidence characteristic evolution based on the national cancer registry in Taiwan. J Oncol. 2020;2020:1408793. doi: 10.1155/2020/1408793. - DOI - PMC - PubMed
    1. Diana A, Carlino F, Giunta EF, et al. Cancer treatment-induced bone loss (CTIBL): state of the art and proper management in breast cancer patients on endocrine therapy. Curr Treat Options Oncol. 2021;22:45. doi: 10.1007/s11864-021-00835-2. - DOI - PMC - PubMed
    1. Waqas K, Lima Ferreira J, Tsourdi E, Body JJ, Hadji P, Zillikens MC. Updated guidance on the management of cancer treatment-induced bone loss (CTIBL) in pre- and postmenopausal women with early-stage breast cancer. J Bone Oncol. 2021;28:100355. doi: 10.1016/j.jbo.2021.100355. - DOI - PMC - PubMed
    1. Stumpf U, Kostev K, Kyvernitakis J, Böcker W, Hadji P. Incidence of fractures in young women with breast cancer—a retrospective cohort study. J Bone Oncol. 2019;18:100254. doi: 10.1016/j.jbo.2019.100254. - DOI - PMC - PubMed

LinkOut - more resources