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. 2025 Feb;19(1):46-53.
doi: 10.31616/asj.2024.0334. Epub 2025 Jan 20.

Computed tomography Hounsfield unit values as a treatment response indicator for spinal metastatic lesions in patients with non-small-cell lung cancer: a retrospective study in Japan

Hiroshi Taniwaki  1 , Sho Dohzono  1 , Ryuichi Sasaoka  2 , Kiyohito Takamatsu  1 , Masatoshi Hoshino  3 , Hiroaki Nakamura  4
Affiliations

Computed tomography Hounsfield unit values as a treatment response indicator for spinal metastatic lesions in patients with non-small-cell lung cancer: a retrospective study in Japan

Hiroshi Taniwaki et al. Asian Spine J. 2025 Feb.

Abstract

Study design: A retrospective study.

Purpose: This study aimed to determine the impact of increased Hounsfield unit (HU) values for metastatic spinal lesions measured via computed tomography on the overall survival of patients with non-small-cell lung cancer (NSCLC) and identify factors associated with increased HU values in metastatic spinal lesions.

Overview of literature: Previous studies have underscored the utility of the HU as a marker of treatment response in metastatic bone lesions. However, no prior studies have explored the relationship between HU changes in response to treatment and overall survival in patients with NSCLC.

Methods: This study included a total of 85 patients between 2016 and 2021. Nonsurgical treatments were provided by the respiratory medicine department. HU values for metastatic spinal lesions were evaluated upon diagnosis of spinal metastasis (baseline) and at 3, 6, and 12 months thereafter. Patients were then divided into two groups based on the median HU increase from baseline to 3 months. Overall survival was assessed using the Kaplan-Meier method.

Results: Based on the median change in HU value (124), 42 and 43 patients were categorized into the HU responder and non-responder groups, respectively. The median overall survival was significantly longer in the HU responder group than in the HU non-responder group (13.7 months vs. 6.4 months, p <0.001). Multiple linear regression analysis revealed that the use of antiresorptive agents and molecularly targeted therapies were factors significantly associated with an increase in HU.

Conclusions: An increase in HU values for metastatic spinal lesions after 3 months of treatment was correlated with a significantly longer overall survival in patients with NSCLC. Thus, HU measurements may not only serve as an easy and quantitative approach for evaluating treatment response in metastatic spinal lesions but also predict overall survival.

Keywords: Hounsfield unit; Lung neoplasms; Molecular targeted therapy; Neoplasm metastasis; Prognosis.

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Conflict of interest statement

Conflict of Interest

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
Region of interest setting of computed tomography images of the metastatic lesions at diagnosis (baseline) of bone metastasis and after treatment. (A) Lytic bone metastasis. (B) Mixed-type bone metastasis. (C) Sclerotic bone metastasis.
Fig. 2
Fig. 2
Overall survival of the Hounsfield unit (HU) responder group versus the non-responder group. CI, confidence interval; HR, hazard ratio.
See this image and copyright information in PMC

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References

    1. Siegel RL, Miller KD, Wagle NS, Jemal A. Cancer statistics, 2023. CA Cancer J Clin. 2023;73:17–48. - PubMed
    1. Brodowicz T, O’Byrne K, Manegold C. Bone matters in lung cancer. Ann Oncol. 2012;23:2215–22. - PMC - PubMed
    1. Al Husaini H, Wheatley-Price P, Clemons M, Shepherd FA. Prevention and management of bone metastases in lung cancer: a review. J Thorac Oncol. 2009;4:251–9. - PubMed
    1. Tsuya A, Kurata T, Tamura K, Fukuoka M. Skeletal metastases in non-small cell lung cancer: a retrospective study. Lung Cancer. 2007;57:229–32. - PubMed
    1. Socinski MA, Obasaju C, Gandara D, et al. Current and emergent therapy options for advanced squamous cell lung cancer. J Thorac Oncol. 2018;13:165–83. - PubMed

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