title: A longitudinal computed tomography study of lenalidomide and bortezomib treatment for multiple myeloma: trabecular microarchitecture and biomechanics assessed using multidetector computed tomography.
abstract: BACKGROUND
  Bone disease is a common feature in patients with multiple myeloma. In this study, we investigated whether lenalidomide, similar to bortezomib, affects the microarchitecture and biomechanics of bones using clinical CT-based FEM.
  
  
  METHODS
  Bone lesions were evaluated using whole-body 64-section multidetector CT scan. For microstructural- and CT/FEM analyses, the volume of interest was defined as a 10-mm thickness of the central part of the L3 vertebral body. Microstructural parameters and mechanical properties were calculated using a 3-D image analysis system. The changes from baseline to the second examination within groups were calculated. Relationships between baseline disease characteristics and percent changes of trabecular parameters were assessed using Spearman correlation analysis.
  
  
  RESULTS
  Thirty-two patients were treated with bortezomib and 18 patients were treated with lenalidomide. At the second CT scan, apparent trabecular number, failure load, and stiffness were decreased in the bortezomib group and failure load and stiffness were increased significantly in the lenalidomide group. In the lenalidomide group, response to chemotherapy was positively associated with increases in failure load (ρ = 0.57; P < .05) and stiffness (ρ = 0.50; P < .05).
  
  
  CONCLUSIONS
  Lenalidomide treatment resulted in significant increases in CT/FEM-derived estimates of bone strength. Response to chemotherapy predicted lenalidomide-induced bone changes and good responders had increased bone strength.
authors.affiliation: Department of Diagnostic Radiology, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshimashi, Japan. Electronic address: my-takasu@syd.odn.ne.jp.
authors.forename: Miyuki
authors.initials: M
authors.lastname: Takasu
authors.affiliation: Department of Diagnostic Radiology, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshimashi, Japan.
authors.forename: Chihiro
authors.initials: C
authors.lastname: Tani
authors.affiliation: Department of Diagnostic Radiology, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshimashi, Japan.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Kaichi
authors.affiliation: Department of Radiology, Hiroshima Red Cross Hospital and Atomic-Bomb Survivors Hospital, Hiroshimashi, Japan.
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Sakoda
authors.affiliation: Department of Diagnostic Radiology, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshimashi, Japan.
authors.forename: Masao
authors.initials: M
authors.lastname: Kiguchi
authors.affiliation: Department of Diagnostic Radiology, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshimashi, Japan.
authors.forename: Shuji
authors.initials: S
authors.lastname: Date
authors.affiliation: Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Kuroda
authors.affiliation: Department of Radiation Life Sciences, Fukushima Medical University School of Medicine, Fukushima, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Sakai
authors.affiliation: Department of Diagnostic Radiology, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshimashi, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Awai
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D015519:Bone Density; D001847:Bone Diseases / Q000000981:diagnostic imaging* / Q000209:etiology*; D001842:Bone and Bones / Q000000981:diagnostic imaging / Q000473:pathology; D001897:Boronic Acids / Q000008:administration & dosage / Q000627:therapeutic use*; D000069286:Bortezomib; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D000077269:Lenalidomide; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D009101:Multiple Myeloma / Q000150:complications* / Q000188:drug therapy*; D011719:Pyrazines / Q000008:administration & dosage / Q000627:therapeutic use*; D012189:Retrospective Studies; D013792:Thalidomide / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D020533:Angiogenesis Inhibitors; D000970:Antineoplastic Agents; D001897:Boronic Acids; D011719:Pyrazines; D013792:Thalidomide; D000069286:Bortezomib; D000077269:Lenalidomide
keywords: CT-based finite element analysis; Lenalidomide; Multidetector computed tomography; Multiple myeloma