title: Low-dose biplanar skeletal survey versus digital skeletal survey in multiple myeloma.
abstract: OBJECTIVE
  To evaluate the low-dose biplanar (LDB) skeletal survey (SS) for the assessment of focal bone involvement in patients with multiple myeloma (MM) as compared with digital SS and to compare the two techniques in terms of image quality, patient comfort and radiation exposure.
  
  
  METHODS
  Fifty-six consecutive patients with newly diagnosed or first relapsed MM underwent LDB and digital SS on the same day. These were assessed by two radiologists for the detection of focal bone lesions. In the case of discordance, whole-body MR imaging was performed. Image quality, patient comfort and radiation dose were also assessed.
  
  
  RESULTS
  Fifty-six patients (M:30, F:26, mean age, 62 years) with newly diagnosed (n = 21) or first relapse MM (n = 35) were enrolled. A total of 473 bone lesions in 46 patients (82 %) were detected. Out of that total, digital SS detected significantly more lesions than LDB SS (451 [95.35 %] versus 467 [98.73 %]), especially in osteopenic and obese patients. Overall patient satisfaction was greater with LDB SS (48.6 %) compared with digital SS (2.7 %). The radiation dose was significantly reduced (by a factor of 7.8) with the LDB X-ray device.
  
  
  CONCLUSIONS
  Low-dose biplanar skeletal surveys cannot replace digital SS in all patients suffering from multiple myeloma.
  
  
  CONCLUSIONS
  • Low-dose biplanar skeletal surveys can readily assess bone lesions in multiple myeloma. • In marked radiographic osteopenia and obesity, LDB SS diagnostic performance is reduced. • Low-dose biplanar skeletal surveys cannot yet replace digital SS in all MM patients.
authors.affiliation: Departments of Pediatric and Musculoskeletal Imaging, University Hospital of Jeanne de Flandre and University of Lille 2, Lille, France. nboutry@gmail.com
authors.forename: Nathalie
authors.initials: N
authors.lastname: Boutry
authors.forename: Bastien
authors.initials: B
authors.lastname: Dutouquet
authors.forename: Xavier
authors.initials: X
authors.lastname: Leleu
authors.forename: Marie-Hélène
authors.initials: MH
authors.lastname: Vieillard
authors.forename: Alain
authors.initials: A
authors.lastname: Duhamel
authors.forename: Anne
authors.initials: A
authors.lastname: Cotten
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001851:Bone Diseases, Metabolic / Q000473:pathology; D001842:Bone and Bones / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000000981:diagnostic imaging* / Q000473:pathology*; D009765:Obesity / Q000473:pathology; D015588:Observer Variation; D011446:Prospective Studies; D011829:Radiation Dosage; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods; D012008:Recurrence