Computerized tomography-based radiotherapy improves heterotopic ossification outcomes

Waleed F. Mourad, Satya Packianathan, John K. Ma, Claus (Chunli) Yang, Rania A. Shourbaji, Rui He, Zhen Zhang, Madhava Rao Kanakamedala, Majid A. Khan, Paul Mobit, Evangelia Katsoulakis, Thomas Nabhani, Richard Jennelle, George V. Russell, Srinivasan Vijayakumar

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Purpose: To report the impact of computerized tomography (CT) based radiotherapy (RT) on heterotopic ossification (HO) outcomes. Methods: This is a single institution, retrospective study of 532 patients who were treated for traumatic acetabular fractures (TAF). All patients underwent open-reduction internal-fixation (ORIF) of the TAF followed by RT for HO prophylaxis. Postoperative RT was delivered within 72. h, in a single fraction of 7. Gy. The patients were divided into 2 groups based on RT planning: CT (A) vs. clinical setup (B). Results: At a median follow up of 8. years the incidence of HO was 21.6%. Multivariate regression analysis revealed that group (A) vs. (B) had HO incidence of 6.6% vs. 24.6% (p. <. 0.001), respectively. Furthermore, HO Brooker grade ≥. 3 was observed in 2.2% vs. 10.8% (p. =. 0.007) in group (A) vs. (B), respectively. Thus, the odds of developing HO and Brooker grades ≥. 3 were 4.7 and 4.5 times higher, respectively, in patients who underwent clinical setup. Conclusion: Our data suggest that using CT based RT allowed more accurate delineation of the tissues and better clinical outcomes. Although CT-based RT is associated with additional cost the efficacy of CT-based RT reduces the risk of HO, thereby decreasing the need for additional surgical interventions.

Original languageEnglish (US)
Pages (from-to)132-136
Number of pages5
JournalBone
Volume57
Issue number1
DOIs
StatePublished - Nov 1 2013

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Heterotopic Ossification
Radiotherapy
Tomography
Incidence
Multivariate Analysis
Retrospective Studies
Regression Analysis
Costs and Cost Analysis

Keywords

  • Acetabular fracture
  • Computerized tomography
  • Heterotopic ossification
  • Radiation therapy

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Histology
  • Physiology

Cite this

Mourad, W. F., Packianathan, S., Ma, J. K., Yang, C. C., Shourbaji, R. A., He, R., ... Vijayakumar, S. (2013). Computerized tomography-based radiotherapy improves heterotopic ossification outcomes. Bone, 57(1), 132-136. https://doi.org/10.1016/j.bone.2013.08.001

Computerized tomography-based radiotherapy improves heterotopic ossification outcomes. / Mourad, Waleed F.; Packianathan, Satya; Ma, John K.; Yang, Claus (Chunli); Shourbaji, Rania A.; He, Rui; Zhang, Zhen; Kanakamedala, Madhava Rao; Khan, Majid A.; Mobit, Paul; Katsoulakis, Evangelia; Nabhani, Thomas; Jennelle, Richard; Russell, George V.; Vijayakumar, Srinivasan.

In: Bone, Vol. 57, No. 1, 01.11.2013, p. 132-136.

Research output: Contribution to journalArticle

Mourad, WF, Packianathan, S, Ma, JK, Yang, CC, Shourbaji, RA, He, R, Zhang, Z, Kanakamedala, MR, Khan, MA, Mobit, P, Katsoulakis, E, Nabhani, T, Jennelle, R, Russell, GV & Vijayakumar, S 2013, 'Computerized tomography-based radiotherapy improves heterotopic ossification outcomes', Bone, vol. 57, no. 1, pp. 132-136. https://doi.org/10.1016/j.bone.2013.08.001
Mourad WF, Packianathan S, Ma JK, Yang CC, Shourbaji RA, He R et al. Computerized tomography-based radiotherapy improves heterotopic ossification outcomes. Bone. 2013 Nov 1;57(1):132-136. https://doi.org/10.1016/j.bone.2013.08.001
Mourad, Waleed F. ; Packianathan, Satya ; Ma, John K. ; Yang, Claus (Chunli) ; Shourbaji, Rania A. ; He, Rui ; Zhang, Zhen ; Kanakamedala, Madhava Rao ; Khan, Majid A. ; Mobit, Paul ; Katsoulakis, Evangelia ; Nabhani, Thomas ; Jennelle, Richard ; Russell, George V. ; Vijayakumar, Srinivasan. / Computerized tomography-based radiotherapy improves heterotopic ossification outcomes. In: Bone. 2013 ; Vol. 57, No. 1. pp. 132-136.
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abstract = "Purpose: To report the impact of computerized tomography (CT) based radiotherapy (RT) on heterotopic ossification (HO) outcomes. Methods: This is a single institution, retrospective study of 532 patients who were treated for traumatic acetabular fractures (TAF). All patients underwent open-reduction internal-fixation (ORIF) of the TAF followed by RT for HO prophylaxis. Postoperative RT was delivered within 72. h, in a single fraction of 7. Gy. The patients were divided into 2 groups based on RT planning: CT (A) vs. clinical setup (B). Results: At a median follow up of 8. years the incidence of HO was 21.6{\%}. Multivariate regression analysis revealed that group (A) vs. (B) had HO incidence of 6.6{\%} vs. 24.6{\%} (p. <. 0.001), respectively. Furthermore, HO Brooker grade ≥. 3 was observed in 2.2{\%} vs. 10.8{\%} (p. =. 0.007) in group (A) vs. (B), respectively. Thus, the odds of developing HO and Brooker grades ≥. 3 were 4.7 and 4.5 times higher, respectively, in patients who underwent clinical setup. Conclusion: Our data suggest that using CT based RT allowed more accurate delineation of the tissues and better clinical outcomes. Although CT-based RT is associated with additional cost the efficacy of CT-based RT reduces the risk of HO, thereby decreasing the need for additional surgical interventions.",
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AU - Mourad, Waleed F.

AU - Packianathan, Satya

AU - Ma, John K.

AU - Yang, Claus (Chunli)

AU - Shourbaji, Rania A.

AU - He, Rui

AU - Zhang, Zhen

AU - Kanakamedala, Madhava Rao

AU - Khan, Majid A.

AU - Mobit, Paul

AU - Katsoulakis, Evangelia

AU - Nabhani, Thomas

AU - Jennelle, Richard

AU - Russell, George V.

AU - Vijayakumar, Srinivasan

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N2 - Purpose: To report the impact of computerized tomography (CT) based radiotherapy (RT) on heterotopic ossification (HO) outcomes. Methods: This is a single institution, retrospective study of 532 patients who were treated for traumatic acetabular fractures (TAF). All patients underwent open-reduction internal-fixation (ORIF) of the TAF followed by RT for HO prophylaxis. Postoperative RT was delivered within 72. h, in a single fraction of 7. Gy. The patients were divided into 2 groups based on RT planning: CT (A) vs. clinical setup (B). Results: At a median follow up of 8. years the incidence of HO was 21.6%. Multivariate regression analysis revealed that group (A) vs. (B) had HO incidence of 6.6% vs. 24.6% (p. <. 0.001), respectively. Furthermore, HO Brooker grade ≥. 3 was observed in 2.2% vs. 10.8% (p. =. 0.007) in group (A) vs. (B), respectively. Thus, the odds of developing HO and Brooker grades ≥. 3 were 4.7 and 4.5 times higher, respectively, in patients who underwent clinical setup. Conclusion: Our data suggest that using CT based RT allowed more accurate delineation of the tissues and better clinical outcomes. Although CT-based RT is associated with additional cost the efficacy of CT-based RT reduces the risk of HO, thereby decreasing the need for additional surgical interventions.

AB - Purpose: To report the impact of computerized tomography (CT) based radiotherapy (RT) on heterotopic ossification (HO) outcomes. Methods: This is a single institution, retrospective study of 532 patients who were treated for traumatic acetabular fractures (TAF). All patients underwent open-reduction internal-fixation (ORIF) of the TAF followed by RT for HO prophylaxis. Postoperative RT was delivered within 72. h, in a single fraction of 7. Gy. The patients were divided into 2 groups based on RT planning: CT (A) vs. clinical setup (B). Results: At a median follow up of 8. years the incidence of HO was 21.6%. Multivariate regression analysis revealed that group (A) vs. (B) had HO incidence of 6.6% vs. 24.6% (p. <. 0.001), respectively. Furthermore, HO Brooker grade ≥. 3 was observed in 2.2% vs. 10.8% (p. =. 0.007) in group (A) vs. (B), respectively. Thus, the odds of developing HO and Brooker grades ≥. 3 were 4.7 and 4.5 times higher, respectively, in patients who underwent clinical setup. Conclusion: Our data suggest that using CT based RT allowed more accurate delineation of the tissues and better clinical outcomes. Although CT-based RT is associated with additional cost the efficacy of CT-based RT reduces the risk of HO, thereby decreasing the need for additional surgical interventions.

KW - Acetabular fracture

KW - Computerized tomography

KW - Heterotopic ossification

KW - Radiation therapy

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