Article Figures & Data
Figures
- FIGURE 1.
A 10-y-old boy, with osteosarcoma of left femoral metaphysis, received chemotherapy before and after surgery. He had marginal excision of tumor and bone transport with Ilizarov external fixator. (A) Radiograph shows callus formation in diaphysial distraction segment. (B) Blood-pool image and delayed image show increased activities in distraction segments. Increased activities are also shown in growth plates in both images. ROI was set on distraction segment and symmetric ROI was set on contralateral normal area as control. Uptake ratio of blood-pool image was 1.3, and uptake ratio of delayed image was 4.4.
- FIGURE 2.
Box plot graphics of DR in groups A–C. Box indicates lower and upper quartiles, and central line and open circle in box are median and mean, respectively. Upper and lower ends of vertical line indicate 90 percentile and 10 percentile, respectively. NS = not statistically significant. DR of group A was significantly lower than that of other 2 groups.
- FIGURE 3.
Distraction indices of poor and good consolidation groups. Distraction index of poor consolidation group was significantly larger than that of good consolidation group. However, poor consolidation group was not differentiated from good consolidation group because of significant overlap.
- FIGURE 4.
Comparison of poor and good consolidation group in PI, BPR, and DR. Each horizontal dashed line indicates optimal cutoff levels obtained by ROC analysis, which were 1.1 in PI, 1.2 in BPR, and 2.2 in DR.
- FIGURE 5.
ROC curves of detectability of poor consolidation group in PI, BPR, and DR. Area under ROC curve of DR was significantly larger than that of other 2 indices. FPF = false-positive fraction; TPF = true-positive fraction; Az = area under ROC curve.
Tables
Parameter Group A Group B Group C P Age (y) 18 ± 11 28 ± 23 29 ± 20 NS Length (cm) 8.2 ± 2.8 5.8 ± 1.1 4.9 ± 3.5 NS Waiting period (d) 10.2 ± 3.0 8.3 ± 3.8 8.5 ± 4.0 NS Distraction (d) 132 ± 93 94 ± 30 90 ± 92 NS Consolidation (d) 166 ± 99 140 ± 76 150 ± 143 NS Total duration (d) 299 ± 118 234 ± 65 240 ± 167 NS NS = not statistically significant.
Parameter (d/cm) Group A Group B Group C P Distraction index 15.8 ± 6.5 16.7 ± 6.3 18.7 ± 8.9 NS Maturation index 22.3 ± 15.6 25.1 ± 14.4 51.8 ± 70.0 NS External fixation index 38.0 ± 15.8 41.8 ± 12.9 70.5 ± 69.9 NS NS = not statistically significant.
- TABLE 3
Length and Periods of Distraction Osteogenesis: Comparisons Between Poor and Good Consolidation Groups
Parameter Poor consolidation Good consolidation P Age (y) 27 ± 18 27 ± 20 NS Length (cm) 6.2 ± 2.4 5.6 ± 3.7 NS Waiting period (d) 9.6 ± 4.0 8.8 ± 3.6 NS Distraction (d) 148 ± 115 91 ± 80 NS Consolidation (d) 172 ± 104 155 ± 135 NS Total duration (d) 319 ± 120 246 ± 151 NS NS = not statistically significant.
Parameter CL Sensitivity Specificity Accuracy PPV NPV PI 1.1 4/11 (36) 44/49 (90) 48/60 (80) 4/9 (44) 44/51 (86) BPR 1.2 6/11 (55) 46/49 (94) 52/60 (87) 6/9 (67) 46/51 (90) DR 2.2 9/11 (82) 47/49 (96) 56/60 (93) 9/11 (82) 47/49 (96) CL = cutoff level; PPV = positive predictive value; NPV = negative predictive value.
Values in parentheses are percentages.
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