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03.02.2023 | Musculoskeletal

Predictive model based on DCE-MRI and clinical features for the evaluation of pain response after stereotactic body radiotherapy in patients with spinal metastases

verfasst von: Yongye Chen, Qizheng Wang, Guangjin Zhou, Ke Liu, Siyuan Qin, Weili Zhao, Peijin Xin, Huishu Yuan, Hongqing Zhuang, Ning Lang

Erschienen in: European Radiology | Ausgabe 7/2023

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Abstract

Objective

To investigate the correlation of conventional MRI, DCE-MRI and clinical features with pain response after stereotactic body radiotherapy (SBRT) in patients with spinal metastases and establish a pain response prediction model.

Methods

Patients with spinal metastases who received SBRT in our hospital from July 2018 to April 2022 consecutively were enrolled. All patients underwent conventional MRI and DCE-MRI before treatment. Pain was assessed before treatment and in the third month after treatment, and the patients were divided into pain-response and no-pain-response groups. A multivariate logistic regression model was constructed to obtain the odds ratio and 95% confidence interval (CI) for each variable. C-index was used to evaluate the model’s discrimination performance.

Results

Overall, 112 independent spinal lesions in 89 patients were included. There were 73 (65.2%) and 39 (34.8%) lesions in the pain-response and no-pain-response groups, respectively. Multivariate analysis showed that the number of treated lesions, pretreatment pain score, Karnofsky performance status score, Bilsky grade, and the DCE-MRI quantitative parameter K^trans were independent predictors of post-SBRT pain response in patients with spinal metastases. The discrimination performance of the prediction model was good; the C index was 0.806 (95% CI: 0.721–0.891), and the corrected C-index was 0.754.

Conclusion

Some imaging and clinical features correlated with post-SBRT pain response in patients with spinal metastases. The model based on these characteristics has a good predictive value and can provide valuable information for clinical decision-making.

Key Points

• SBRT can accurately irradiate spinal metastases with ablative doses.

• Predicting the post-SBRT pain response has important clinical implications.

• The prediction models established based on clinical and MRI features have good performance.

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Titel: Predictive model based on DCE-MRI and clinical features for the evaluation of pain response after stereotactic body radiotherapy in patients with spinal metastases
verfasst von: Yongye Chen
Qizheng Wang
Guangjin Zhou
Ke Liu
Siyuan Qin
Weili Zhao
Peijin Xin
Huishu Yuan
Hongqing Zhuang
Ning Lang
Publikationsdatum: 03.02.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 7/2023
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-023-09437-y

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Predictive model based on DCE-MRI and clinical features for the evaluation of pain response after stereotactic body radiotherapy in patients with spinal metastases