ArticleCancer imaging : the official publication of the International Cancer Imaging Society2020
Radiation-induced occult insufficiency fracture or bone metastasis after radiotherapy for cervical cancer? The nomogram based on quantitative apparent diffusion coefficients for discrimination.
Article in Cancer imaging : the official publication of the International Cancer Imaging Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
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2 citing papers in PubMed, 1 synthesis or guideline pooled it, 2 citations in OpenAlex.
- Added diagnostic performance of diffusion-weighted imaging for differentiating malignant from benign gallbladder lesions: a systematic review with meta-analysis.Abdominal radiology (New York) · 2025Pooled it
- Case Report: A Case of Neuroendocrine Carcinoma of the Endometrium with Deficient DNA Mismatch Repair Had Achieved Clinical Complete Response after Combination Therapy.Oncology research · 2026Article
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9 authors at 5 institutions in 1 country.
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Abstract
backgroundRadiation-induced insufficiency fractures (IF) is frequently occult without fracture line, which may be mistaken as metastasis. Quantitative apparent diffusion coefficient (ADC) shows potential value for characterization of benign and malignant bone marrow diseases. The purpose of this study was to develop a nomogram based on multi-parametric ADCs in the differntiation of occult IF from bone metastasis after radiotherapy (RT) for cervical cancer.
methodsThis study included forty-seven patients with cervical cancer that showed emerging new bone lesions in RT field during the follow-up. Multi-parametric quantitative ADC values were measured for each lesion by manually setting region of interests (ROIs) on ADC maps, and the ROIs were copied to adjacent normal muscle and bone marrow. Six parameters were calculated, including ADC
resultsA total of 75 bone lesions were identified, including 48 occult IFs and 27 bone metastases. There were significant differences in the six ADC parameters between occult IFs and bone metastases (p < 0.05), the ADC ratio (lesion/ muscle) showed an optimal diagnostic efficacy, with an area under ROC (AUC) of 0.887, the sensitivity of 95.8%, the specificity of 81.5%, respectively. Regarding combined diagnosis, ADC
conclusionsMulti-parametric ADC values demonstrate potential value for differentiating occult IFs from bone metastasis, a nomogram based on the combination of ADC
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