Accuracy and precision of the spinal instability neoplastic score (SINS) for predicting vertebral compression fractures after radiotherapy in spinal metastases: a meta-analysis
Abstract Radiotherapy has played an important role in the treatment of spinal metastases. One of the major complications of radiotherapy is vertebral compression fracture (VCF). Although the spinal instability neoplastic score (SINS) was developed for evaluating spinal instability in patients with s...
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| Format: | Article |
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Nature Portfolio
2021-03-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-021-84975-3 |
| _version_ | 1829477787698724864 |
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| author | Young Rak Kim Chang-Hyun Lee Seung Heon Yang Seung-Jae Hyun Chi Heon Kim Sung Bae Park Ki-Jeong Kim Chun Kee Chung |
| author_facet | Young Rak Kim Chang-Hyun Lee Seung Heon Yang Seung-Jae Hyun Chi Heon Kim Sung Bae Park Ki-Jeong Kim Chun Kee Chung |
| author_sort | Young Rak Kim |
| collection | DOAJ |
| description | Abstract Radiotherapy has played an important role in the treatment of spinal metastases. One of the major complications of radiotherapy is vertebral compression fracture (VCF). Although the spinal instability neoplastic score (SINS) was developed for evaluating spinal instability in patients with spinal metastases, it is also commonly used to predict VCF after radiotherapy in patients with spinal metastases. However, its accuracy for predicting radiotherapy-induced VCF and precision remain controversial. The aim of this study was to clarify the diagnostic value of the SINS to predict radiotherapy-induced VCF and to make recommendations for improving its diagnostic power. We searched core databases and identified 246 studies. Fourteen studies were analyzed, including 7 studies (with 1269 segments) for accuracy and 7 studies (with 280 patients) for precision. For accuracy, the area under the summary receiver operating characteristic curve was 0.776. When a SINS cut-off value of 7 was used, as was done in the included studies, the pooled sensitivity was 0.790 and the pooled specificity was 0.546. For precision, the summary estimate of interobserver agreement was the highest dividing 2 categories based on a cut-off value of 7, and the value was 0.788. The body collapse showed moderate relationship and precision with the VCF. The lytic tumor of bone lesion showed high accuracy and fair reliability, while location had excellent reliability, but low accuracy. The SINS system can be used to predict the occurrence of VCF after radiotherapy in spinal metastases with moderate accuracy and substantial reliability. Increasing the cut-off value and revising the domains may improve the diagnostic performance to predict the VCF of the SINS. |
| first_indexed | 2024-12-14T17:03:27Z |
| format | Article |
| id | doaj.art-e1ef1f292d2848ab90a758a7723f895d |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-12-14T17:03:27Z |
| publishDate | 2021-03-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-e1ef1f292d2848ab90a758a7723f895d2022-12-21T22:53:48ZengNature PortfolioScientific Reports2045-23222021-03-0111111010.1038/s41598-021-84975-3Accuracy and precision of the spinal instability neoplastic score (SINS) for predicting vertebral compression fractures after radiotherapy in spinal metastases: a meta-analysisYoung Rak Kim0Chang-Hyun Lee1Seung Heon Yang2Seung-Jae Hyun3Chi Heon Kim4Sung Bae Park5Ki-Jeong Kim6Chun Kee Chung7Department of Neurosurgery, Seoul National University HospitalDepartment of Neurosurgery, Seoul National University HospitalDepartment of Neurosurgery, Seoul National University HospitalDepartment of Neurosurgery, Spine Center, Seoul National University Bundang HospitalDepartment of Neurosurgery, Seoul National University HospitalDepartment of Neurosurgery, Seoul National University Boramae HospitalDepartment of Neurosurgery, Spine Center, Seoul National University Bundang HospitalDepartment of Neurosurgery, Seoul National University HospitalAbstract Radiotherapy has played an important role in the treatment of spinal metastases. One of the major complications of radiotherapy is vertebral compression fracture (VCF). Although the spinal instability neoplastic score (SINS) was developed for evaluating spinal instability in patients with spinal metastases, it is also commonly used to predict VCF after radiotherapy in patients with spinal metastases. However, its accuracy for predicting radiotherapy-induced VCF and precision remain controversial. The aim of this study was to clarify the diagnostic value of the SINS to predict radiotherapy-induced VCF and to make recommendations for improving its diagnostic power. We searched core databases and identified 246 studies. Fourteen studies were analyzed, including 7 studies (with 1269 segments) for accuracy and 7 studies (with 280 patients) for precision. For accuracy, the area under the summary receiver operating characteristic curve was 0.776. When a SINS cut-off value of 7 was used, as was done in the included studies, the pooled sensitivity was 0.790 and the pooled specificity was 0.546. For precision, the summary estimate of interobserver agreement was the highest dividing 2 categories based on a cut-off value of 7, and the value was 0.788. The body collapse showed moderate relationship and precision with the VCF. The lytic tumor of bone lesion showed high accuracy and fair reliability, while location had excellent reliability, but low accuracy. The SINS system can be used to predict the occurrence of VCF after radiotherapy in spinal metastases with moderate accuracy and substantial reliability. Increasing the cut-off value and revising the domains may improve the diagnostic performance to predict the VCF of the SINS.https://doi.org/10.1038/s41598-021-84975-3 |
| spellingShingle | Young Rak Kim Chang-Hyun Lee Seung Heon Yang Seung-Jae Hyun Chi Heon Kim Sung Bae Park Ki-Jeong Kim Chun Kee Chung Accuracy and precision of the spinal instability neoplastic score (SINS) for predicting vertebral compression fractures after radiotherapy in spinal metastases: a meta-analysis Scientific Reports |
| title | Accuracy and precision of the spinal instability neoplastic score (SINS) for predicting vertebral compression fractures after radiotherapy in spinal metastases: a meta-analysis |
| title_full | Accuracy and precision of the spinal instability neoplastic score (SINS) for predicting vertebral compression fractures after radiotherapy in spinal metastases: a meta-analysis |
| title_fullStr | Accuracy and precision of the spinal instability neoplastic score (SINS) for predicting vertebral compression fractures after radiotherapy in spinal metastases: a meta-analysis |
| title_full_unstemmed | Accuracy and precision of the spinal instability neoplastic score (SINS) for predicting vertebral compression fractures after radiotherapy in spinal metastases: a meta-analysis |
| title_short | Accuracy and precision of the spinal instability neoplastic score (SINS) for predicting vertebral compression fractures after radiotherapy in spinal metastases: a meta-analysis |
| title_sort | accuracy and precision of the spinal instability neoplastic score sins for predicting vertebral compression fractures after radiotherapy in spinal metastases a meta analysis |
| url | https://doi.org/10.1038/s41598-021-84975-3 |
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