Assessing Bone Strength in Patients with Bone Metastases Using Quantitative CT and Computer Simulation in the MEKANOS Study

What this Trial Is About

Researchers are investigating osteolytic bone metastases and myeloma bone lesions that cause fractures in long bones and vertebrae, leading to limited mobility, surgery, and spinal cord compression. These complications greatly affect quality of life and have significant medical and economic consequences. The study aims to improve fracture risk assessment, which is currently based on simple X-rays and scores like Mirels and SINS, by using quantitative CT scans and advanced numerical simulation techniques to better evaluate the mechanical strength of bones affected by tumors. This observational study enrolls adult patients with bone metastases or myeloma lesions in the upper femur or vertebrae from cancers such as breast, lung, kidney, thyroid, or bladder. Participants undergo quantitative CT scans of the affected bone areas. The mechanical strength of the tumor-affected bone is assessed using finite element analysis FEA, a numerical simulation method that accounts for bone and tumor properties. This approach is compared to traditional fracture risk scores to determine its added value. Participants provide informed consent and have a CT scan performed within 30 days before or 20 days after study inclusion, as part of their usual care. Researchers collect data on bone and tumor characteristics to predict fracture risk and improve management strategies. The primary outcome is the mechanical strength measurement of the tumor-affected femur or vertebrae over 24 months. The study supports better prevention of fractures in patients with bone metastases while coordinating with their oncology treatment.

Tumoral Bone Strength Assessment by Numerical Simulation Using Quantitative CT : the MEKANOS Study