Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
Institute of Medical Imaging, State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou, Jiangsu, China.
J Xray Sci Technol. 2021;29(3):463-475. doi: 10.3233/XST-200811.
To explore the potential value of quantitative parameters derived from dual-energy spectral computed tomography (DESCT) as comparing to the parameters derived from magnetic resonance imaging (MRI) in detecting bone marrow (BM) infiltration and distinguishing different patterns of BM infiltration in patients diagnosed with Multiple myeloma (MM).
This study involved 35MM patients and 15 healthy control subjects who had undergone spinal DESCT and MRI. Pattern assignment was based on visual assessment of MR images, and the regions of interest were defined on both DESCT and apparent diffusion coefficient maps. Quantitative values of DESCT parameters were measured and compared between infiltrated and healthy bone marrow. Receiver operating characteristic (ROC) analysis was performed to determine potential utility of DESCT parameters in identifying BM infiltration and different patterns defined by MRI. Sensitivity and specificity under the optimal thresholds determined by the Youden Index were also calculated.
Statistical differences were observed between the DESCT parameters including Ca(Water), Water(Ca), HAP(Fat), Fat(HAP) and Effective atomic number (Eff-Z) but not for the 70-keV CT value between the infiltrated and healthy BM (all P < 0.001). The 70keV CT value and Ca(Water), HAP(Fat) and Eff-Z values were also found to be statistically different in comparing different infiltration patterns (all P < 0.05). Performance of the model-based parameter Ca/Water was superior in differentiating between infiltrated and healthy BM in which the area under ROC curve, AUC = 0.856 [95% CI, 81.4-89.1%] with sensitivity = 0.841 and specificity = 0.768, as well as between MM patients and control subjects (AUC = 0.910 [95% CI, 79.5-97.3%], sensitivity = 0.829 and specificity = 1.000).
Analysis of DESCT offers potential as a quantitative method to detect infiltrated BM and evaluate infiltration patterns of BM in patients diagnosed with MM.
探讨双能谱 CT（DESCT）定量参数与磁共振成像（MRI）参数相比在检测多发性骨髓瘤（MM）患者骨髓（BM）浸润和区分不同 BM 浸润模式中的潜在价值。
本研究纳入 35 例 MM 患者和 15 例健康对照者，均行脊柱 DESCT 和 MRI 检查。基于 MRI 图像的视觉评估进行模式分配，并在 DESCT 和表观扩散系数图上定义感兴趣区。测量并比较浸润性和正常骨髓的 DESCT 参数的定量值。通过接收者操作特征（ROC）分析确定 DESCT 参数在识别 BM 浸润和 MRI 定义的不同模式中的潜在应用价值。还计算了最佳阈值下由 Youden 指数确定的敏感性和特异性。
在浸润性和正常 BM 之间，观察到 DESCT 参数（包括 Ca（水）、水（Ca）、HAP（脂肪）、脂肪（HAP）和有效原子数（Eff-Z））之间存在统计学差异，但 70keV CT 值无统计学差异（均 P＜0.001）。还发现不同浸润模式之间 70keV CT 值和 Ca（水）、HAP（脂肪）和 Eff-Z 值也存在统计学差异（均 P＜0.05）。基于模型的参数 Ca/Water 在区分浸润性和正常 BM 方面表现更好，ROC 曲线下面积 AUC＝0.856 [95％CI，81.4-89.1％]，敏感性＝0.841，特异性＝0.768，以及区分 MM 患者和对照组（AUC＝0.910 [95％CI，79.5-97.3％]，敏感性＝0.829，特异性＝1.000）。
DESCT 分析有可能成为一种定量方法，用于检测 MM 患者的浸润性 BM 并评估 BM 浸润模式。
