Diagnostic value of whole-body low-dose computed tomography (WBLDCT) in bone lesions detection in patients with multiple myeloma (MM)

Purpose: To assess the role of whole-body low-dose computed tomography (WBLDCT) in the diagnosisand staging of patients with suspicion of multiple myeloma (MM).Materials and methods: A total of 138 patients (76 male and 62 female; mean age 63.5 years, range 50-81years), 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 product40 mAs. Diagnosis of osteolytic lesions was performed on the basis of axial and multiplanar reformattedimages, whereas the assessment of spinal misalignment and fracture was done by using multiplanarreformatted images. The overall dose delivered to each patient was 4.2 mSv. Every patient gave personalinformed consent, as required by our institution guidelines.Results: The diagnosis was established either by histopathology or imaging follow-up (size increase ofover a period time). In all 138 patients, image resolution was diagnostic, enabling correct classification ofmultiple 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 onlyCRAB criterion present. Furthermore, WBLDCT demonstrated pleuro-pulmonary lesions in 20 patients(11 infective, 9 as MM localizations) and 1 renal neoplasia.Conclusion: 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 propermanagement of MM patients.