Περίληψη:
For decades, conventional skeletal survey (CSS) has been the standard imaging technique for multiple myeloma (MM). However, recently whole-body computed tomography (WBCT) has been implemented into the diagnostic criteria of MM. This analysis compares sensitivity and prognostic significance of WBCT and CSS in patients with smoldering MM (SMM) and MM. Fifty-four of 212 patients (25.5%) had a negative CSS and a positive WBCT for osteolytic lesions (P<0.0001). Of 66 patients with SMM based on CSS, 12 (22.2%) had osteolytic lesions on WBCT. In comparison, WBCT failed to detect some bone destructions in the appendicular skeleton possibly due to limitations of the field of view. Presence of lytic bone lesions in WBCT was of borderline prognostic significance (P=0.051) for SMM patients, with a median time to progression of 38 versus 82 months for those without bone destructions. In conclusion, WBCT identifies significantly more sites of bone destruction than CSS. More than 20% of patients with SMM according to CSS have in fact active MM detectable with WBCT. On the basis of this and other studies, WBCT (either computed tomography (CT) alone or as part of a positron emission tomography-CT protocol) should be considered the current standard for the detection of osteolytic lesions in MM. © 2017 The Author(s).
Συγγραφείς:
Hillengass, J.
Moulopoulos, L.A.
Delorme, S.
Koutoulidis, V.
Mosebach, J.
Hielscher, T.
Drake, M.
Rajkumar, S.V.
Oestergaard, B.
Abildgaard, N.
Hinge, M.
Plesner, T.
Suehara, Y.
Matsue, K.
Withofs, N.
Caers, J.
Waage, A.
Goldschmidt, H.
Dimopoulos, M.A.
Lentzsch, S.
Durie, B.
Terpos, E.
Λέξεις-κλειδιά:
adult; aged; appendicular skeleton; Article; bone atrophy; bone destruction; cancer growth; cancer prognosis; cancer staging; cancer survival; cohort analysis; controlled study; conventional skeletal survey; health survey; human; major clinical study; multiple myeloma; positron emission tomography; progression free survival; whole body CT; clinical trial; comparative study; diagnostic imaging; disease free survival; female; male; middle aged; mortality; multicenter study; multiple myeloma; osteolysis; positron emission tomography; retrospective study; survival rate; very elderly; x-ray computed tomography, Adult; Aged; Aged, 80 and over; Disease-Free Survival; Female; Humans; Male; Middle Aged; Multiple Myeloma; Osteolysis; Positron-Emission Tomography; Retrospective Studies; Survival Rate; Tomography, X-Ray Computed
