Abstract
This study compares the sensitivity of whole-body multidetector CT (MDCT) and conventional radiography (CR) in the staging of multiple myeloma (MM). Twenty-nine patients with MM underwent a staging examination both by MDCT and CR. CT examination was performed with a collimation of 64×0.6 mm, a tube potential of 100 kVp, an effective tube current-time product of 100 mAs and automatic dose modulation as low-dose protocol. Number, size and diagnostic confidence of osteolytic lesions were determined and compared. The effective dose of MDCT and CR was assessed. Using MDCT, the detection of osteolysis was increased seven-fold concerning the spine. Ninety-seven lesions in 18 patients were detected exclusively by MDCT. The detection rate concerning the spine, pelvic skeleton and thoracic cage was significantly higher (p≤0.001), and diagnostic confidence was increased by MDCT (p<0.02) compared to CR. Therapy was changed after MDCT in 18.2% of the patients with a clinical suspicion of progressive disease. The estimated effective dose of MDCT (4.8 mSv) and CR (1.7 mSv) was comparable. In conclusion, MDCT has a significantly higher sensitivity and reliability in the detection of osteolysis than CR and can be recommended as standard imaging method in the staging of MM.


Similar content being viewed by others
Explore related subjects
Discover the latest articles and news from researchers in related subjects, suggested using machine learning.References
Durie BGM, Salmon SE (1982) The current status and future prospects of treatment for multiple myeloma. Clin Haematol 11:181–210
Ludwig H (1986) Klinik de Multiplen Myeloms. Onkologe 5:297–306
Durie BGM (1986) Stanging and kinetics of multiple myeloma. Semin Oncol 13:300–309
Durie BGM, Salmon SE (1975) A clinical staging system for multiple myeloma: correlation of measured myeloma cell mass with presenting clinical features, response to treatment and survival. Cancer 36:842–854
Durie B, Kyle R, Belch A, et al (2003) Myeloma management guidelines: a consensus report from the Scientific Advisors of the International Myeloma Foundation. Haematol J 4:379–398
Mulligan ME (2005) Imaging techniques used in the diagnosis, staging, and follow-up of patients with myeloma. Acta Radiol 46:716–724
Mahnken AH, Wildberger JE, Gehbauer G, Schmitz-Rode T, Blaum M, Fabry U, Günther RW (2002) MDCT of the spine in multiple myeloma: comparison with MR imaging and radiography. AJR 178:1729–1436
Horger M, Claussen CD, Bross-Bach U, Vonthein R, Trabold T, Heuschmid M, Pfannenberg C (2005) Whole-body low-dose multidetector row-CT in the diagnosis of multiple myeloma: an alternative to conventional radiography. Eur J Radiology 54:289–297
Althen JN (2005) Automatic tube-current modulation in CT–a comparison between different solutions. Radiat Prot Dosimetry 114:308–312
Mulkens TH, Bellinck P, Baeyaert M, Ghysen D, Van Dijck X, Mussen E, Venstermans C, Termote JL (2005) Use of an automatic exposure control mechanism for dose optimization in multi-detector row CT examinations: clinical evaluation. Radiology 237:213–223
Ewen K (1998) Moderne Bildgebung. Georg Thieme Verlag Stuttgart, New York, pp 35–44
Le Heron JC (1992) Estimation of effective dose to the patient during medical x-ray examinations from measurements of the dose-area product. Phys Med Biol 37:2117–2126
Stamm G, Nagel HD (2002) CT-Expo-ein neues Programm zur Dosisabschätzung im CT. Röfo 174:1570–1576
Boccardo M, Pileri A (1997) Diagnosis, prognosis and standard treatment of multiple myeloma. Haematol Oncol Clin N Am 11:111–131
Tertti R, Alanen A, Remes K (1995) The value of magnstic resonance imaging in screening myeloma lesions of the lumbar spine. Brit J Haematol 91:658–660
Lecouvert FE, Malghem J, Michaux L, Maldague B, Ferrant A, Michaux JL, Vande Berg BC (1999) Skeletal survey in advanced multiple myeloma: radiographic versus MR imaging survey. Brit J Haematol 106:35–39
Stäbler A, Baur A, Bartl R, Munker R, Lamerz R, Reiser MF (1996) Contrast enhancement and quantitative signal analysis in MR imaging of multiple myeloma: assessment of focal and diffuse growth patterns in marrow correlated with biopsies and survival rates. AJR:1029–1036
Schick F (2005) Whole-body MRI at high field: technical limits and clinical potential. Eur Radiol: 946–959
Salomon A, Rahamani R, Seligsohn U, Ben-Artzi F (1984) Multiple myeloma: early vertebral involvement assessed by computerised tomography. Skeletal Radiol 11:258–261
Schreiman JS, McLeod RA, Kyle RA, Beabout JW (1985) Multiple myeloma: evaluation by CT. Radiology 154:483–486
Scutellari PN, Galeotti R, Leprotti S, Piva N, Spanedda R (1997) Role of computerized tomography in the diagnosis of bone disease in multiple myeloma. Radiol Med (Torino) 93:669–675
Baur-Melnyk A, Reiser M (2004) Staging of Multiple Myeloma with MRI: comparison to MSCT and conventional radiography. Radiologe 44:874–881
Zwirewich CV, Mayo JR, Muller NL (1991) Low-dose high-resolution CT of lung parenchyma. Radiology 180:413–417
Lee KS, Primack SL, Staples CA, Mayo JR, Aldrich JE, Muller NL (1994) Chronic infiltrative lung disease: comparison of diagnostic accuracies of radiography and low- and conventional-dose thin-section CT. Radiology 56:521–525
Dammert S, Funke M, Merten HA, Obernauer S, Grabbe E (2002) Multislice helical CT (MSCT) for mid-facial trauma: Optimization of parameters for scanning and reconstruction. Röfo 174:874–879
Tack D, Widelec J, De Maertelaer V, Bailly JM, Delcour C, Gevenois PA (2003) Comparison between low-dose and standard-dose multidetector CT in patients with suspected chronic sinusitis. AJR 181:939–944
Hagtvedt T, Aalokken TM, Notthellen J, Kolbenstvedt A (2003) A new low-dose CT examination compared with standard-dose CT in the diagnosis of acute sinusitis. Eur Radiology 13:976–980
Luz O, Buchgeister M, Klabunde M, Trabold T, Kopp AF, Claussen CD, Heuschmid M (2007) Evaluation of dose exposure in 64-slice CT colonography. Eur Radiol DOI 10.1007/s00330-007-0601-6
Cohnen M, Poll LW, Puettmann C, Ewen K, Saleh A, Mödder U (2003) Effective doses in standard protocols for multi-slice CT scanning. Eur Radiology 13:1148–1153
Husstedt H, Prokop M, Becker H (1998) [Window width as a dosage-relevant factor in high-contrast structures in CT]. Rofo 168:139–143
Ghanem N, Lohmann C, Engelhardt M, Pache G, Uhl M, Saueressig U et al. (2006) Whole-body MRI in the detection of bone marrow infiltration in patients with plasma cell neoplasms in comparison to the radiological skeletal survey. Eur Radiology 16:1005–1014
Nanni C, Zamagni e, Mohsen F, Castellucci P, Tosi P, Cangini D, Salizzoni E, Canini R, Cavo M, Fanti S (2006) Role of 18-F-FDG PET/CT in the assessment of bone involvement in newly diagnosed multiple myeloma: preliminary results. Eur J Nucl Med Mol Imaging 33:525–531
Walde TA, Weiland DE, Leung SB, Kitamura N, Sychterz CJ, Engh Jr CA, Claus AM, Potter HG, Engh Sr CA (2005) Comparison of CT, MRI, and radiographs in assessing pelvic osteolysis: a cadaveric study. Clin Orthop Relat Res 437:138–144
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kröpil, P., Fenk, R., Fritz, L.B. et al. Comparison of whole-body 64-slice multidetector computed tomography and conventional radiography in staging of multiple myeloma. Eur Radiol 18, 51–58 (2008). https://doi.org/10.1007/s00330-007-0738-3
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00330-007-0738-3