Improved Follow-Up and Response Monitoring of Thoracic Cage Involvement in Multiple Myeloma Using a Novel CT Postprocessing Software: The Lessons We Learned
Autor: | Konstantin Nikolaou, Katja Weisel, Georg Bier, Christopher Kloth, Hendrik Ditt, Deedar Farhad Mustafa, Marius Horger |
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Rok vydání: | 2016 |
Předmět: |
Adult
Male medicine.medical_specialty Whole body imaging Ribs Sensitivity and Specificity 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine medicine Humans Whole Body Imaging Radiology Nuclear Medicine and imaging Multiple myeloma Aged Neoplasm Staging Retrospective Studies Aged 80 and over Very Good Partial Response Rib cage business.industry Retrospective cohort study General Medicine Middle Aged medicine.disease Quality Improvement Hematologic Response medicine.anatomical_structure 030220 oncology & carcinogenesis Radiographic Image Interpretation Computer-Assisted Female Radiology Bone marrow Multiple Myeloma Tomography X-Ray Computed business Nuclear medicine Software Progressive disease Follow-Up Studies |
Zdroj: | American Journal of Roentgenology. 206:57-63 |
ISSN: | 1546-3141 0361-803X |
Popis: | The purpose of this study is to evaluate the benefit of using novel CT postprocessing software that generates unfolded rib images for more-accurate evaluation of multiple myeloma (MM) at follow-up, response monitoring, and visualization of treatment-related bone changes.Between January 2012 and February 2015, 40 consecutive patients with MM underwent repeated whole-body reduced-dose CT at our institution. The results were retrospectively evaluated and compared with established hematologic markers. Unfolded rib reformatted images were compared with 5- and 1-mm-thick slices with regard to bone changes, bone marrow attenuation, and bone sclerosis.Hematologic response categories at follow-up were complete response (CR; n = 2), very good partial response (VGPR; n = 1), partial response (PR; n = 9), stable disease (n = 9), and progressive disease (PD; n = 19). The number of lesions increased in 11 patients (all with PD), decreased in two patients (both with CR), and stayed unchanged in 27 patients. The size of the lesions increased in 14 patients (all with PD), decreased in five patients (two with CR, two with PR, and one with stable disease), and remained unchanged in 21 patients. There was a mean (± SD) difference of 27.99 ± 19.71 HU in bone marrow attenuation for patients with PD (p0.0001) and -31.24 ± 13.57 HU in the responders group (p = 0.002), whereas patients with stable disease showed stable bone marrow attenuation at follow-up (mean, -3.37 ± 10.55 HU). Increased bone sclerosis was detected in 12 patients (all of whom were receiving therapy). The sensitivity and specificity of unfolded rib images, 5-mm slices, and 1-mm slices were, respectively, 78.9% and 100%, 52.6% and 100%, and 63.2% and 100% for accurate bone response assessment; 100% and 95.2%, 94.74% and 42.9%, and 89.47% and 47.62% for bone marrow attenuation; and 100% and 100%, 58.3% and 100%, and 91.67% and 100% for sclerosis.For therapy response assessment, unfolded rib reading is more accurate than transverse CT slices. |
Databáze: | OpenAIRE |
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