Diagnostic value of whole-body low-dose computed tomography (WBLDCT) in bone lesions detection in patients with multiple myeloma (MM).
OBJECTIVE
To assess the role of whole-body low-dose computed tomography (WBLDCT) in the diagnosis and staging of patients with suspicion of multiple myeloma (MM).


METHODS
A total of 138 patients (76 male and 62 female; mean age 63.5 years, range 50-81 years), with early MM, underwent WBLDCT protocol study, performed on 16-slice scanner (Brilliance, Philips Medical System, Eindhoven, The Netherlands): tube voltage 120 kV; tube current time product 40 mAs. Diagnosis of osteolytic lesions was performed on the basis of axial and multiplanar reformatted images, whereas the assessment of spinal misalignment and fracture was done by using multiplanar reformatted images. The overall dose delivered to each patient was 4.2 mSv. Every patient gave personal informed consent, as required by our institution guidelines.


RESULTS
The diagnosis was established either by histopathology or imaging follow-up (size increase of over a period time). In all 138 patients, image resolution was diagnostic, enabling correct classification of multiple myeloma patients. WBLDCT showed a total of 328 pathologic bone findings in 81/138 patients. CT scanning resulted in complete evaluation of the bone lesions in these areas of the skeleton: skull (42), humerus (15), femur (20), ribs (7), scapulae (13), pelvis (35), clavicle (13), sternum (10), cervical (39), dorsal (65), lombar (48) and sacral rachis (21). In 40/81 bone involvement detected by CT was the only CRAB criterion present. Furthermore, WBLDCT demonstrated pleuro-pulmonary lesions in 20 patients (11 infective, 9 as MM localizations) and 1 renal neoplasia.


CONCLUSIONS
WBLDCT, detecting bone marrow localizations and demonstrating extra-osseous findings, with a fast scanning time and high resolution images, is a reliable imaging-based tool for a proper management of MM patients.
School of Medicine, University of Milano-Bicocca, Via Pergolesi 33, 20900 Monza (MB), Italy; Department of Diagnostic Radiology, H. San Gerardo, Via Pergolesi 33, 20900 Monza (MB), Italy. Electronic address: davide.atena@tiscalinet.it.
Davide
D
Ippolito
Valeria
V
Besostri
Pietro Andrea
PA
Bonaffini
Fausto
F
Rossini
Alessandro
A
Di Lelio
Sandro
S
Sironi
D000368:Aged; D001859:Bone Neoplasms / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000000981:diagnostic imaging*; D009367:Neoplasm Staging; D011829:Radiation Dosage; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*; D051598:Whole Body Imaging; D014915:Whole-Body Counting
Bone lesions; Low-dose computed tomography; Multidetector computed tomography; Multiple myeloma; Skeletal radiology