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COMPUTER-AIDED EFFECTIVE FRACTURE RISK STRATIFICATION OF PATIENTS WITH VERTEBRAL METASTASES FOR PERSONALISED TREATMENT THROUGH ROBUST COMPUTATIONAL MODELS VALIDATED IN CLINICAL SETTINGS

Project description

Biomechanical computational models support spinal surgery decision making

Cancer metastases to bone reach the spine in 30-70 % of cases, resulting in fracture in about a third of cases. Decisions on whether to operate are based solely on radiographic images. Current scoring systems do not yield a definitive decision in more than half of cases making the decision highly subjective. The EU-funded METASTRA project aims to integrate AI and local biomechanics into biomechanical computational models to stratify patients with high fracture risk due to spine metastasis and identify the best personalised surgical treatment. The team’s highly trained and validated models will be combined in a decision support system that meets future regulatory requirements and tested in a multicentric prospective observational study.

Objective

Cancer patients (2.7M in Europe) with a positive prognosis are exposed to a high incidence of secondary tumours (≈1M). Bone metastases spread to the spine in 30-70% cases, reducing the load bearing capacity of the vertebrae and triggering fracture in 30% cases. Clinicians have only two options: either operate to stabilise the spine, or leave the patient exposed to a high fracture risk. The decision is highly subjective and can either lead to unnecessary surgery, or a fracture significantly affecting the quality of life and cancer treatment.

The standard-of-care to classify patients with vertebral metastasis are scoring systems based on radiographic images, with little consideration of the local biomechanics. Current scoring systems are unable to establish an indication for surgery in around 60% of cases. Thus, there is an unmet need to accurately and timely quantify the risk of fracture to improve patient stratification and identify the best personalised treatment.

This interdisciplinary project will develop Artificial Intelligence (AI)- and Physiology-based (VPH) biomechanical computational models to stratify patients with spine metastasis who are at high risk of fracture and to identify the best personalised surgical treatment. After rigorous model training with clinical (2000 retrospective cases) and biomechanical (120 ex vivo specimens) data, the new approach will be tested in a multicentric prospective observational study (200 patients). The models will be combined in a decision support system (DSS) enabling clinicians to successfully stratify metastatic patients. The models and the DSS will be designed so as to be suitable for regulatory requirements and future exploitation.

METASTRA will propose new guidelines for the stratification and management of metastatic patients. METASTRA approach is expected to cut the uncertain diagnoses from the current 60% down to 20% of cases. This will reduce patient suffering, and allow cutting expenditure by 2.4B€/year.

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HORIZON-RIA - HORIZON Research and Innovation Actions

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Call for proposal

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(opens in new window) HORIZON-HLTH-2022-TOOL-12-two-stage

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Coordinator

ALMA MATER STUDIORUM - UNIVERSITA DI BOLOGNA
Net EU contribution

Net EU financial contribution. The sum of money that the participant receives, deducted by the EU contribution to its linked third party. It considers the distribution of the EU financial contribution between direct beneficiaries of the project and other types of participants, like third-party participants.

€ 1 474 386,25
Address
VIA ZAMBONI 33
40126 Bologna
Italy

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Region
Nord-Est Emilia-Romagna Bologna
Activity type
Higher or Secondary Education Establishments
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Total cost

The total costs incurred by this organisation to participate in the project, including direct and indirect costs. This amount is a subset of the overall project budget.

€ 1 474 386,25

Participants (11)

Partners (4)

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