School of Medicine, University of Milano-Bicocca, Via Pergolesi 33, 20900 Monza (MB), Italy; Department of Diagnostic Radiology, H. San Gerardo, Via Pergolesi 33, 20900 Monza (MB), Italy.
Eur J Radiol. 2013 Dec;82(12):2322-7. doi: 10.1016/j.ejrad.2013.08.036. Epub 2013 Sep 8.
To assess the role of whole-body low-dose computed tomography (WBLDCT) in the diagnosis and staging of patients with suspicion of multiple myeloma (MM).
A total of 138 patients (76 male and 62 female; mean age 63.5 years, range 50-81 years), with early MM, underwent WBLDCT protocol study, performed on 16-slice scanner (Brilliance, Philips Medical System, Eindhoven, The Netherlands): tube voltage 120 kV; tube current time product 40 mAs. Diagnosis of osteolytic lesions was performed on the basis of axial and multiplanar reformatted images, whereas the assessment of spinal misalignment and fracture was done by using multiplanar reformatted images. The overall dose delivered to each patient was 4.2 mSv. Every patient gave personal informed consent, as required by our institution guidelines.
The diagnosis was established either by histopathology or imaging follow-up (size increase of over a period time). In all 138 patients, image resolution was diagnostic, enabling correct classification of multiple myeloma patients. WBLDCT showed a total of 328 pathologic bone findings in 81/138 patients. CT scanning resulted in complete evaluation of the bone lesions in these areas of the skeleton: skull (42), humerus (15), femur (20), ribs (7), scapulae (13), pelvis (35), clavicle (13), sternum (10), cervical (39), dorsal (65), lombar (48) and sacral rachis (21). In 40/81 bone involvement detected by CT was the only CRAB criterion present. Furthermore, WBLDCT demonstrated pleuro-pulmonary lesions in 20 patients (11 infective, 9 as MM localizations) and 1 renal neoplasia.
WBLDCT, detecting bone marrow localizations and demonstrating extra-osseous findings, with a fast scanning time and high resolution images, is a reliable imaging-based tool for a proper management of MM patients.
评估全身低剂量 CT（WBLDCT）在疑似多发性骨髓瘤（MM）患者的诊断和分期中的作用。
共 138 例患者（76 例男性，62 例女性；平均年龄 63.5 岁，范围 50-81 岁），早期 MM 患者，行 WBLDCT 协议研究，使用 16 层扫描仪（Brilliance，Philips Medical System，Eindhoven，荷兰）：管电压 120kV；管电流时间乘积 40mAs。溶骨性病变的诊断是基于轴位和多平面重建图像，而脊柱错位和骨折的评估是通过多平面重建图像进行的。每位患者的总剂量为 4.2mSv。每位患者均根据我们机构的指南获得个人知情同意。
诊断依据为组织病理学或影像学随访（一段时间内的大小增加）。在所有 138 例患者中，图像分辨率均具有诊断意义，能够正确分类多发性骨髓瘤患者。WBLDCT 在 81/138 例患者中显示总共 328 处病理性骨病变。CT 扫描可全面评估骨骼这些区域的骨病变：颅骨（42 个）、肱骨（15 个）、股骨（20 个）、肋骨（7 个）、肩胛骨（13 个）、骨盆（35 个）、锁骨（13 个）、胸骨（10 个）、颈椎（39 个）、胸椎（65 个）、腰椎（48 个）和骶骨（21 个）。在 40/81 例 CT 检测到的骨受累患者中，唯一的 CRAB 标准存在。此外，WBLDCT 在 20 例患者中显示了胸膜-肺病变（11 例感染性，9 例为 MM 定位）和 1 例肾肿瘤。
WBLDCT 可检测骨髓定位并显示骨外发现，具有快速扫描时间和高分辨率图像，是 MM 患者合理管理的可靠影像学工具。
