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Response evaluation of giant-cell tumor of bone treated by denosumab: Histogram and texture analysis of CT images

 Jisook Yi  ;  Young Han Lee  ;  Sang Kyum Kim  ;  Seung Hyun Kim  ;  Ho-Taek Song  ;  Kyoo-Ho Shin  ;  Jin-Suck Suh 
 JOURNAL OF ORTHOPAEDIC SCIENCE, Vol.23(3) : 570-577, 2018 
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BACKGROUND: This study aimed to compare computed tomography (CT) features, including tumor size and textural and histogram measurements, of giant-cell tumors of bone (GCTBs) before and after denosumab treatment and determine their applicability in monitoring GCTB response to denosumab treatment. METHODS: This retrospective study included eight patients (male, 3; female, 5; mean age, 33.4 years) diagnosed with GCTB, who had received treatment by denosumab and had undergone pre- and post-treatment non-contrast CT between January 2010 and December 2016. This study was approved by the institutional review board. Pre- and post-treatment size, histogram, and textural parameters of GCTBs were compared by the Wilcoxon signed-rank test. Pathological findings of five patients who underwent surgery after denosumab treatment were evaluated for assessment of treatment response. RESULTS: Relative to the baseline values, the tumor size had decreased, while the mean attenuation, standard deviation, entropy (all, P = 0.017), and skewness (P = 0.036) of the GCTBs had significantly increased post-treatment. Although the difference was statistically insignificant, the tumors also exhibited increased kurtosis, contrast, and inverse difference moment (P = 0.123, 0.327, and 0.575, respectively) post-treatment. Histologic findings revealed new bone formation and complete depletion or decrease in the number of osteoclast-like giant cells. CONCLUSION: The histogram and textural parameters of GCTBs changed significantly after denosumab treatment. Knowledge of the tendency towards increased mean attenuation and heterogeneity but increased local homogeneity in post-treatment CT histogram and textural features of GCTBs might aid in treatment planning and tumor response evaluation during denosumab treatment.
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1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Sang Kyum(김상겸) ORCID logo https://orcid.org/0000-0003-0768-9923
Kim, Seung Hyun(김승현) ORCID logo https://orcid.org/0000-0002-3878-1944
Suh, Jin Suck(서진석) ORCID logo https://orcid.org/0000-0001-9455-9240
Song, Ho Taek(송호택) ORCID logo https://orcid.org/0000-0002-6655-2575
Shin, Kyoo Ho(신규호)
Lee, Young Han(이영한) ORCID logo https://orcid.org/0000-0002-5602-391X
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