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Rapid study assessment in follow-up whole-body computed tomography in patients with multiple myeloma using a dedicated bone subtraction software

  • Computed Tomography
  • Published:
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Abstract

Objectives

The diagnostic reading of follow-up low-dose whole-body computed tomography (WBCT) examinations in patients with multiple myeloma (MM) is a demanding process. This study aimed to evaluate the diagnostic accuracy and benefit of a novel software program providing rapid-subtraction maps for bone lesion change detection.

Methods

Sixty patients (66 years ± 10 years) receiving 120 WBCT examinations for follow-up evaluation of MM bone disease were identified from our imaging archive. The median follow-up time was 292 days (range 200–641 days). Subtraction maps were calculated from 2-mm CT images using a nonlinear deformation algorithm. Reading time, correctly assessed lesions, and disease classification were compared to a standard reading software program. De novo clinical reading by a senior radiologist served as the reference standard. Statistics included Wilcoxon rank-sum test, Cohen’s kappa coefficient, and calculation of sensitivity, specificity, positive/negative predictive value, and accuracy.

Results

Calculation time for subtraction maps was 84 s ± 24 s. Both readers reported exams faster using subtraction maps (reader A, 438 s ± 133 s; reader B, 1049 s ± 438 s) compared to PACS software (reader A, 534 s ± 156 s; reader B, 1486 s ± 587 s; p < 0.01). The course of disease was correctly classified by both methods in all patients. Sensitivity for lesion detection in subtraction maps/conventional reading was 92%/80% for reader A and 88%/76% for reader B. Specificity was 98%/100% for reader A and 95%/96% for reader B.

Conclusion

A software program for the rapid-subtraction map calculation of follow-up WBCT scans has been successfully tested and seems suited for application in clinical routine. Subtraction maps significantly facilitated reading of WBCTs by reducing reading time and increasing sensitivity.

Key Points

• A novel algorithm has been successfully applied to generate motion-corrected bone subtraction maps of whole-body low-dose CT scans in less than 2 min.

• Motion-corrected bone subtraction maps significantly facilitate the reading of follow-up whole-body low-dose CT scans in multiple myeloma by reducing reading time and increasing sensitivity.

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Abbreviations

MM:

Multiple myeloma

PACS:

Picture archiving and communication system

R-ISS:

Revised International Staging System

S&D:

Salmon and Durie

WBCT:

Whole-body computed tomography

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Acknowledgments

The authors warmly thank Prof. Inke König for her skillful statistical advice.

Funding

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

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Authors and Affiliations

  1. Department of Radiology and Nuclear Medicine, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany

    M. M. Sieren, F. Brenne, H. Kienapfel, T. H. Oechtering, A. Fürschke, F. Wegner, E. Stahlberg, J. Barkhausen & A. Frydrychowicz

  2. Fraunhofer Institute for Digital Medicine MEVIS, Lübeck, Germany

    A. Hering & S. Heldmann

  3. Department of Haematology and Oncology, UKSH, Campus Lübeck, Lübeck, Germany

    N. Gebauer

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  1. M. M. Sieren
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Correspondence to M. M. Sieren.

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The scientific guarantor of this publication is Prof. Dr. Alex Frydrychowicz, Department of Radiology and Nuclear Medicine, UKSH, Campus Lübeck.

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The authors declare that they have no conflict of interest.

Statistics and biometry

Prof. Inke König kindly provided statistical advice for this manuscript.

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Written informed consent was waived by the institutional review board.

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Sieren, M.M., Brenne, F., Hering, A. et al. Rapid study assessment in follow-up whole-body computed tomography in patients with multiple myeloma using a dedicated bone subtraction software. Eur Radiol 30, 3198–3209 (2020). https://doi.org/10.1007/s00330-019-06631-9

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  • DOI: https://doi.org/10.1007/s00330-019-06631-9

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