| Objective: To study the changes of multiple myeloma patients’ parameters before and after induction therapy by using energy spectrum CT multiparameter imaging technology,and to predict the efficacy evaluation value of multiple myeloma newly diagnosed patients after induction therapy.Methods: A total of 28 patients diagnosed with multiple myeloma from September 2020 to August 2021 in The Affiliated Hospital of Qinghai University were enrolled and underwent four cycles of induction therapy.Lesions were delineated for all patients according to ROI selection and delineation criteria,and corresponding CT parameters of energy spectrum were obtained,including the concentration of each paired base substance(mg/cm~3)and the slope of energy spectrum curve.After induction therapy,efficacy was assessed and patients were divided into deep response group(s CR,CR and VGPR)and non-deep response group(PR,MR,SD and PD).(1)The parameters of the two groups were compared before and after treatment.Secondly,the difference between the change value and change rate of each parameter after induction treatment was compared between the two groups.(2)ROC curve was used to judge the ability of the change rate of each base substance to concentration and the change rate of energy spectrum curve slope to evaluate the response depth after MM induction therapy.Results:(1)There were no significant differences in the concentrations of HAP(Fat),Fat(HAP),Calcium(Water)and Water(Calcium)groups before induction treatment between the deep remission group and the absolute values of the concentration before treatment in the non-deep remission group.(2)Compared with the concentration before treatment,the absolute values of HAP(Fat)and Calcium(Water)compounds were increased after induction treatment in both groups;Fat(HAP)based substance concentration decreased in absolute value.The absolute values of the concentrations of Water(Calcium)were all decreased,and the difference was statistically significant only in the deep remission group before and after induction treatment,but not in the non-deep remission group.The absolute slope of energy spectrum CT energy spectrum curve increases.(3)After treatment,the change value and change rate of the deep remission group were higher than those of the non-deep remission group,and the difference of HAP(Fat),Fat(HAP),Calcium(Water)and the slope and change rate of energy spectrum curves were statistically significant between the two groups.Water(Calcium)difference was not statistically significant.(4)THE AUC value of HAP(Fat)change rate was 0.874,the AUC value of Fat(HAP)change rate was 0.830,and the AUC value of Calcium(Water)change rate was 0.875.When the change rates before and after induction treatment were 46.02%,94.5%,60.33%,respectively,The sensitivity was 66.7%,94.4%,83.3%,and the specificity was 84.9%,71.0%,89.2%,respectively.The AUC value of the change rate of energy spectrum curve was 0.700.When the change rate before and after induction therapy was 50.86%,the sensitivity and specificity were72.2% and 67.7%,respectively.Conclusion: The change value and change rate of basal substance concentration and slope of energy spectrum curve before and after treatment in the deep remission group were higher than those in the non-deep remission group,suggesting that the change of energy spectrum CT parameters can be used to indicate the remission degree.Secondly,the ROC curve was drawn to further prove that the rate of change of energy spectrum CT parameters after induction therapy has the ability to diagnose the deep response after induction therapy in MM patients.Therefore,the results of this study indicate that energy spectrum CT multi-parameter imaging has application value in judging the efficacy. |
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