Hello,
As we look toward various “RADS” to standardize the diagnosis and reporting of MSK bone and soft tissue lesions (Bone rads, ST rads, OT rads), I am trying to make sense of where quantitative measurements are being used as “bio markers,” how these apply to the various “rads” under development and how the community uses this at large. (Is there a standard among the community?)
There are three measurements that come up:
1. The mean 885 HU threshold for sclerotic bone lesions (and the max, as reported in (American Journal of Roentgenology. 2016;207: 362-368.
https://www.ajronline.org/doi/full/10.2214/AJR.15.15559). Do you use this number and if so, how do you use it (what scenarios) and what is your experience? For example, do you use this in helping with narrowing a differential diagnosis for an incidental sclerotic bone lesion in someone without a known history of cancer? Do you only apply it for patients with known sclerotic bone metastases?
2. 20-30% drop out on OOP for bone lesions. If you use this, have you seen scenarios where it fails and where you would advise caution (MM, early bone metastasis disease, for example).
3. Adc thresholds for soft tissue and bone lesions.
I recognize there are various papers for each of these. If you please reply directly to me with your thoughts / experience / opinions, I will string together replies into one email to share so there are not a bunch of reply alls.
Thank you for your time.
Adam Singer
