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Whole-body ultra-low dose CT using spectral shaping for detection of osteolytic lesion in multiple myeloma

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The aim of this study was to investigate the radiation dose and image quality of a whole-body low-dose CT (WBLDCT) using spectral shaping at 100 kV (Sn 100 kV) for the assessment of osteolytic lesions in patients with multiple myeloma.


Thirty consecutive patients were retrospectively selected, who underwent a WBLDCT on a third-generation dual-source CT (DSCT) (Sn 100 kV, ref. mAs: 130). They were matched with patients, who were examined on a second-generation DSCT with a standard low-dose protocol (100 kV, ref. mAs: 111). Objective and subjective image quality, radiation exposure as well as the frequency of osteolytic lesions were evaluated.


All scans were of diagnostic image quality. Subjective overall image quality was significantly higher in the study group (p = 0.0003). Objective image analysis revealed that signal intensities, signal-to-noise ratio and contrast-to-noise ratio of the bony structures were equal or significantly higher in the control group. There was no significant difference in the frequency of osteolytic lesions (p = 0.259). The median effective dose of the study protocol was significantly lower (1.45 mSv vs. 5.65 mSv; p < 0.0001).


WBLDCT with Sn 100 kV can obtain sufficient image quality for the depiction of osteolytic lesions while reducing the radiation dose by approximately 74%.

Key points

Spectral shaping using tin filtration is beneficial for whole-body low-dose CT

Sn 100 kV yields sufficient image quality for depiction of osteolytic lesions

Whole-body low-dose CT can be performed with a median dose of 1.5 mSv

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Advanced Modeled Iterative Reconstruction


Body mass index


Contrast-to-noise ratio


Computed tomography

CTDIvol :

Volumetric CT dose index


Dose length product


Effective dose


Hounsfield unit


Interquartile range


Iterative reconstruction


Multiple myeloma


Region of interest


Sinogram Affirmed Iterative Reconstruction


Standard deviation


Signal-to-noise ratio


Whole-body low-dose CT


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The authors state that this work has not received any funding.

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Correspondence to Saravanabavaan Suntharalingam.

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The scientific guarantor of this publication is Kai Nassenstein, MD.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Ethical approval

The study was approved by the local ethics committee.

Informed consent

Written informed consent was waived by the Institutional Review Board due to the retrospective character of the study and anonymised data evaluation.


• retrospective

• observational

• performed at one institution

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Suntharalingam, S., Mikat, C., Wetter, A. et al. Whole-body ultra-low dose CT using spectral shaping for detection of osteolytic lesion in multiple myeloma. Eur Radiol 28, 2273–2280 (2018).

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