Clinical assessment

To compare the FE predictions with clinical fracture risk assessments, we generated digitally reconstructed radiographs (DRRs) from the CT scans in this study.²⁰ We asked two radiation oncologists with broad expertise in palliative radiotherapy, who regularly discuss and refer patients to the orthopaedics department (C1 and C2), and one experienced orthopaedic oncology surgeon (C3) to individually assess the DRRs just as in daily practice, without providing any further information. First, they indicated whether the patient carried a high risk of fracture requiring elective surgery. Subsequently, we asked them to judge whether the cortical disruption caused by the metastasis was > 30 mm.¹⁴