Description du projet
Modéliser le risque de fracture chez les patients atteints d’un cancer
La métastase osseuse est un phénomène fréquent de nombreux types de cancer, elle est à l’origine de douleurs intenses, de fractures osseuses et d’une détérioration de la qualité de vie des patients. L’ampleur des lésions osseuses provoquées par les métastases est actuellement évaluée à l’aide de la tomodensitométrie quantitative (QCT pour «quantitative computed tomography»), une approche qui manque de sensibilité et de spécificité. Pour surmonter ces limites, le projet METABONE, financé par l’UE, développe une nouvelle méthodologie de modélisation capable de prédire le risque de fractures du fémur métastatique. L’approche combine des données numériques et expérimentales, et devrait devenir un outil plus précis pour les oncologues afin de choisir les stratégies locomotrices à mettre en place chez les patients atteints d’un cancer.
Objectif
Osteolytic bone metastases are responsible for long bone fracture leading to restricted mobility, surgery, or medullar compression that severely alter quality of life and have a huge socio-economic impact. Current fragility scores to estimate the fracture risk in patients with metastatic femur are based on qualitative evaluation from Quantitative Computed Tomography (QCT) scans and lack sensitivity and specificity. Efforts are now made towards the development of patient-specific finite element models to assess the strength of tumoral bone segments, but their accuracy is hampered by several limitations, including limited knowledge of metastatic bone mechanical properties, simulations performed only for single stance loading condition, and simulations providing a global failure criteria. The aim of METABONE is, therefore, to use a novel approach to better predict the fracture risk of metastatic femur. A patient-specific finite element model will be developed based on QCT scans, which will include the real material properties of ex vivo human metastatic bone determined experimentally in the first part of the project. The composition and mechanical behaviour of diseased bone tissue are hypothesised to be rather different from healthy tissue and influential of femoral strength. This model will be used clinically on patients with osteolytic lesions located in proximal femur to assess the fracture risk during daily life activities, using a local failure criteria and a range of different loading conditions. This novel methodology, combining experimental and numerical approaches, is expected to significantly improve the accuracy of fracture risk prediction. Successful completion of METABONE will have the potential to guide clinical decision making, by providing clinicians with a more accurate tool to optimize locomotor strategy and oncology program, in order to prevent bone fracture, improve survival and quality of life of the patients.
Champ scientifique
Programme(s)
Régime de financement
MSCA-IF - Marie Skłodowska-Curie Individual Fellowships (IF)Coordinateur
69622 Villeurbanne Cedex
France