title: Comparison of whole-body 64-slice multidetector computed tomography and conventional radiography in staging of multiple myeloma.
abstract: This study compares the sensitivity of whole-body multidetector CT (MDCT) and conventional radiography (CR) in the staging of multiple myeloma (MM). Twenty-nine patients with MM underwent a staging examination both by MDCT and CR. CT examination was performed with a collimation of 64x0.6 mm, a tube potential of 100 kVp, an effective tube current-time product of 100 mAs and automatic dose modulation as low-dose protocol. Number, size and diagnostic confidence of osteolytic lesions were determined and compared. The effective dose of MDCT and CR was assessed. Using MDCT, the detection of osteolysis was increased seven-fold concerning the spine. Ninety-seven lesions in 18 patients were detected exclusively by MDCT. The detection rate concerning the spine, pelvic skeleton and thoracic cage was significantly higher (p< or =0.001), and diagnostic confidence was increased by MDCT (p<0.02) compared to CR. Therapy was changed after MDCT in 18.2% of the patients with a clinical suspicion of progressive disease. The estimated effective dose of MDCT (4.8 mSv) and CR (1.7 mSv) was comparable. In conclusion, MDCT has a significantly higher sensitivity and reliability in the detection of osteolysis than CR and can be recommended as standard imaging method in the staging of MM.
authors.affiliation: Institut für Diagnostische Radiologie der Universität Düsseldorf, Moorenstrasse 5, 40225 Düsseldorf, Germany. pkroepil@gmx.de
authors.forename: Patric
authors.initials: P
authors.lastname: Kröpil
authors.forename: Roland
authors.initials: R
authors.lastname: Fenk
authors.forename: Lars B
authors.initials: LB
authors.lastname: Fritz
authors.forename: Dirk
authors.initials: D
authors.lastname: Blondin
authors.forename: Guido
authors.initials: G
authors.lastname: Kobbe
authors.forename: Ulrich
authors.initials: U
authors.lastname: Mödder
authors.forename: Mathias
authors.initials: M
authors.lastname: Cohnen
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000000981:diagnostic imaging* / Q000473:pathology; D009367:Neoplasm Staging; D010014:Osteolysis / Q000000981:diagnostic imaging; D011446:Prospective Studies; D011829:Radiation Dosage; D011857:Radiographic Image Interpretation, Computer-Assisted; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed / Q000379:methods*; D051598:Whole Body Imaging