Preliminary Study On The Clinical Application Of Whole-body Low-dose Computed Tomography In Multiple Myeloma

Purpose:To assess the feasibility of whole-body low-dose computed tomography(WBLDCT)for patients with newly diagnosed multiple myeloma(MM),and the relationship between clinical prognostic parameters and bone disease.Material and Methods:41 patients with newly diagnosed MM received WBLDCT as part of their diagnostic work-up.The CT scan was performed on a 64-slice CT scanner(Discovery CT HD 750,GE Healthcare)with tube voltage of 140kV;tube current time product of 50 mAs.Images were reconstructed with adaptive statistical iterative reconstruction(ASIR)technique.Two experienced radiologists analyzed and graded images.The volume CT dose index(CTDIvol)and dose length product(DLP)were recorded to calculate the effective dose.The differences in the number and extent of osteolytic involvement with other imaging examinations were compared.In addition,a comparison between the CT imaging findings,clinical staging and the percentage of the plasma cells in bone marrow was made.Five eytogenetie abnormalities of bone marrow myeloma cells were tested by fluorescence in situ hybridization(FISH).Results:The average effective dose of WBLDCT in our research was 4.75 m Sv.Comparing with the conventional radiography more osteolytic lesions were identified by WBLDCT,the positive sensitivity of WBLDCT and conventional radiography were 85.4%(35/41)and 57%(16/28)respectively.The number of lesions was uncorrelated with the bone marrow monoclonal plasma cell ratio(p>0.05).Patients with positive osteolytic lesions had higher DS staging(p= < 0.01)and ISS staging(p < 0.05),while the correlation between the IGH gene deletion and positive osteolytic lesions was negative.Conclusion:WBLDCT is an effective alternative for patients with a new diagnosis of multiple myeloma and assessment of complications.More bone lesions could be detected byWBLDCT comparing with conventional radiography.Osteolysis determined by WBLDCT is relevant to clinical DS stages and ISS stages.The correlation between the IGH gene deletion and positive osteolytic lesions was negative.