How lesions with axial-transverse cortical involvement in the the femoral shaft affect fracture risk

The spread of primary cancer to distant organs such as bones in advanced disease results in metastatic bone disease (MBD). Areas affected by MBD develop into abnormal tissue called lesions. These bone lesions decrease the overall load-bearing capacity and increases the risk of fractures. Clinically, fracture risk is assessed using the Mirels’ scoring system [1]. Recently, CT-based finite element (FE) analyses have been employed for risk evaluation, suggesting that cortical involvement significantly raises fracture risk [2]. This study uses the loss of femur stiffness as an indicator of the effect of axial cortical involvement (ACI) and transverse cortical involvement (TCI) of lesions in the femoral shaft on fracture risk.