Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Tuebingen, Germany (S.W.).
Siemens Healthcare GmbH, Diagnostic Imaging, Forchheim, Germany (B.K.).
Acad Radiol. 2022 Feb;29(2):245-254. doi: 10.1016/j.acra.2021.01.029. Epub 2021 Mar 8.
To assess focal multiple myeloma bone lesions via dual-energy CT-based virtual noncalcium (VNCa) bone marrow imaging in relation to the overall hematological disease status and MRI findings.
We retrospectively evaluated 103 focal osteolytic lesions of the axial skeleton in VNCa bone marrow images of 32 patients. Region of interest-based attenuation measurements were correlated with T1w signal intensity and apparent diffusion coefficient (ADC). Results were compared between patients in active and inactive disease. Receiver operating characteristic analysis was performed to determine a cut-off value of VNCa attenuation for differentiation between the two groups. Standard of reference was the overall disease status according to International Myeloma Working Group response criteria.
Mean attenuation difference between lesions and background bone marrow was significantly lower in inactive disease (16 HU, SD 30) compared to active disease (35 HU, SD 29). VNCa attenuation measurement allowed for differentiation between active and inactive disease with a sensitivity of 92% and a specificity of 58% at a cut-off value of -21 HU. VNCa attenuation was negatively correlated to T1w signal intensity (Spearman's ρ -0.617, p < 0.001) and positively correlated to ADC (Spearman's ρ 0.521, p < 0.001).
Quantitative assessment of attenuation of focal osteolytic lesions in VNCa bone marrow images allows differentiation between overall active and inactive disease with higher attenuation signifying an increasing likelihood of active disease. This is supported by a significant positive correlation between the attenuation and the ADC, as well as a corresponding inverse correlation to T1w signal intensity.
通过双能 CT 虚拟非钙（VNCa）骨髓成像评估多发性骨髓瘤骨病变与整体血液疾病状态和 MRI 发现的关系。
我们回顾性评估了 32 例患者 VNCa 骨髓图像中 103 个轴向溶骨性病变的区域。通过基于感兴趣区的衰减测量值与 T1w 信号强度和表观扩散系数（ADC）进行相关性分析。比较了活动期和非活动期患者的结果。进行了受试者工作特征分析，以确定区分两组的 VNCa 衰减的截断值。参考标准是根据国际骨髓瘤工作组反应标准的整体疾病状态。
与活动期疾病相比，非活动期疾病的病变与背景骨髓之间的平均衰减差异明显更低（16 HU，SD 30）。VNCa 衰减测量值允许在活动期和非活动期之间进行区分，其灵敏度为 92%，特异性为 58%，截断值为-21 HU。VNCa 衰减与 T1w 信号强度呈负相关（Spearman's ρ -0.617，p < 0.001），与 ADC 呈正相关（Spearman's ρ 0.521，p < 0.001）。
在 VNCa 骨髓图像中对焦点溶骨性病变衰减的定量评估允许对整体活动期和非活动期疾病进行区分，较高的衰减表示活动期疾病的可能性增加。这得到了衰减与 ADC 之间存在显著正相关以及与 T1w 信号强度之间存在相应的负相关的支持。
