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Whole-body low-dose computed tomography (WBLDCT) in staging and re-staging of multiple myeloma

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Abstract

The objective of this study is to evaluate the prognostic features of multiple myeloma (MM) using whole-body low-dose computed tomography (WBLDCT). One hundred three patients with biopsy-proven MM who underwent WBLDCT were retrospectively enrolled. The evolution of osteolytic lesions overtime was performed by measuring the maximum axial diameter at the baseline (T0) and the end of follow-up (Te), by using a cut-off value of 10 mm. The location and dimension of up to three lesions were registered. The time-to-fracture (TTF) was recorded. Sixty-three percent of patients presented a focal pattern, 22% a diffuse pattern, and 15% a combined one. Seventy-two percent of patients with lesions ≤ 10 mm presented stability, 27% a dimensional increase, and 1% a decrease. Patients with lesions >10 mm showed a statistically significant difference regarding the mean difference of axial diameter between T0 and Te (p = 0.015). Patients with lesions >10 mm showed an odds ratio (OR) of 29.8 (95%CIs 3.8–230.5) to develop at least one fracture. Mean TTF was significantly lower in patients with lesions >10 mm in comparison with lesions ≤ 10 mm (9 ± 3 vs 23 ± 7 months, respectively, p = 0.011). WBLDCT represents a reliable imaging-based tool for proper management of MM patients, showing that diffuse form or small lytic lesions may deserve a less frequent follow-up.

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Data availability

All data generated or analyzed during this study are included in this published article.

Abbreviations

ALARA:

As low as reasonably achievable

CT:

Computed tomography

CTDIvol:

CT dose index volume

DLP:

Dose length product

ED:

Effective dose

EMD:

Extramedullary disease

FOV:

Field of view

IMWG:

International Myeloma Working Group

MM:

Multiple myeloma

MGUS:

Monoclonal Gammopathy of Undetermined Significance

MPR:

MultiPlanar Reconstruction

MRI:

Magnetic resonance imaging

O-MAR:

Metal Artifact Reduction for Orthopedic Implants

PET:

Positron emission tomography

WBLDCT:

Whole-body low-dose CT

WBXR:

Whole-body X-ray survey

WL:

Window level

WW:

Window width

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Authors and Affiliations

  1. Department of Diagnostic Radiology, San Gerardo Hospital, Via Pergolesi 33, 20900, Monza, MB, Italy

    Davide Ippolito, Teresa Giandola, Cesare Maino, Anna Pecorelli, Maria Ragusi, Marco Porta, Davide Gandola & Cammillo Talei Franzesi

  2. School of Medicine, University of Milano-Bicocca, Via Cadore 48, 20900, Monza, MB, Italy

    Davide Ippolito, Teresa Giandola, Cesare Maino, Anna Pecorelli, Maria Ragusi, Marco Porta, Davide Gandola, Cammillo Talei Franzesi & Sandro Sironi

  3. Department of Diagnostic Radiology, H Papa Giovanni XXIII, Piazza OMS 1, 24127, Bergamo, BG, Italy

    Sandro Sironi

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  1. Davide Ippolito
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  2. Teresa Giandola
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Correspondence to Cesare Maino.

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Ethics approval

Local Ethical Committee’s review of the protocol deemed that formal approval was not required owing to the retrospective, observational, and anonymous nature of this study.

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All patients signed the informed consent form to be eligible for this study.

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Ippolito, D., Giandola, T., Maino, C. et al. Whole-body low-dose computed tomography (WBLDCT) in staging and re-staging of multiple myeloma. Ann Hematol 100, 1241–1249 (2021). https://doi.org/10.1007/s00277-021-04468-1

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  • DOI: https://doi.org/10.1007/s00277-021-04468-1

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