Radiomics on radiography predicts giant cell tumor histologic response to denosumab

Research output: Contribution to journalArticlepeer-review


Objective: Denosumab is an established targeted systemic therapy for treatment of giant cell tumor of bone (GCTB). We sought to determine whether treatment response could be quantified from radiomics analysis of radiographs taken longitudinally during treatment. Materials and methods: Pre- and post-treatment radiographs of 10 GCTB tumors from 10 patients demonstrating histologic response after treatment with denosumab were analyzed. Intensity- and texture-based radiomics features for each manually segmented tumor were calculated. Radiomics features were compared pre- and post-treatment in tumors. Results: Mean intensity (p = 0.033) significantly increased while skewness (p = 0.028) significantly decreased after treatment. Post-treatment increases in fractal dimensions (p = 0.057) and abundance (p = 0.065) approached significance. A potential linear correlation in mean (p = 0.005; ΔMean = 0.022 * duration − 0.026) with treatment duration was observed. Conclusion: Radiomics analysis of plain radiographs quantifies time-dependent matrix mineralization and trabecular reconstitution that mark positive response of giant cell tumors of bone to denosumab.

Original languageEnglish (US)
Pages (from-to)1881-1887
Number of pages7
JournalSkeletal Radiology
Issue number9
StatePublished - Sep 2021
Externally publishedYes


  • Denosumab
  • Giant cell tumor
  • Radiograph
  • Radiomics
  • Treatment response

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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