Department of Medicine and Health Sciences "V. Tiberio", University of Molise, Campobasso, Italy.
Hell J Nucl Med. 2020 Sep-Dec;23(3):264-271. doi: 10.1967/s002449912206. Epub 2020 Dec 14.
Whole body low dose computed tomography (WBLDCT) is the first-choice imaging modality to identify bone involvement in multiple myeloma (MM). Because the unenhanced LDCT co-registered to positron emission tomography (PET) (LDCT/PET) has similar technical characteristics to WBLDCT, we aimed to assess its reliability in the detection of bone disease, for employing fluorine-18-fluorodeoxyglucose (F-FDG) PET/CT as unique multimodality imaging method in MM patients.
Thirty three consecutive MM patients were prospectively enrolled and evaluated with WBLDCT to assess bone involvement. In addition, patients underwent F-FDG PET/CT using a disease-tailored optimized LDCT protocol. To compare both methods, skeletal anatomical regions were identified and a per-region and per-patient analysis were performed using Cohen's k test. Low dose computed tomography/PET sensitivity, specificity and accuracy were also calculated.
The two imaging modalities resulted highly concordant considering both patient-based (k=0.841) and region-based analysis; some discrepancies were observed in dorsal spine (k=0.809) and thorax (k=0.756). Low dose computed tomography/PET sensitivity, specificity and accuracy were 89.4%, 98.3% and 93.5%, respectively.
Low dose computed tomography co-registered PET has comparable performance to WBLDCT. If confirmed on a lager sample, these encouraging results suggest the possibility to use this multimodal hybrid imaging as the only method for MM evaluation, rather than both exams, providing both morphologic and metabolic information in one session with impact on patient compliance, health care spending and especially radiation exposure.
全身低剂量计算机断层扫描（WBLDCT）是识别多发性骨髓瘤（MM）骨骼受累的首选影像学方法。由于与正电子发射断层扫描（PET）联合的未增强低剂量 CT（LDCT/PET）具有与 WBLDCT 相似的技术特征，我们旨在评估其在检测骨骼疾病方面的可靠性，以便将氟-18-氟代脱氧葡萄糖（F-FDG）PET/CT 作为 MM 患者的独特多模态成像方法。
前瞻性纳入 33 例连续 MM 患者，使用 WBLDCT 评估骨骼受累情况。此外，患者还接受了针对疾病优化的 LDCT 方案的 F-FDG PET/CT。为了比较两种方法，我们确定了骨骼解剖区域，并使用 Cohen's k 检验进行了区域和患者的分析。还计算了低剂量 CT/PET 的敏感性、特异性和准确性。
考虑到基于患者和基于区域的分析，两种成像方式高度一致（k=0.841）；在胸椎（k=0.756）和胸椎（k=0.809）中观察到一些差异。低剂量 CT/PET 的敏感性、特异性和准确性分别为 89.4%、98.3%和 93.5%。
联合 PET 的低剂量 CT 具有与 WBLDCT 相当的性能。如果在更大的样本中得到证实，这些令人鼓舞的结果表明，这种多模态混合成像有可能作为 MM 评估的唯一方法，而不是两种检查方法，在一次检查中提供形态学和代谢信息，从而提高患者的依从性、医疗保健支出，特别是辐射暴露。
