Improved MDCT monitoring of pelvic myeloma bone disease through the use of a novel longitudinal bone subtraction post-processing algorithm.
Eur Radiol
; 27(7): 2969-2977, 2017 Jul.
Article
in En
| MEDLINE
| ID: mdl-27882427
ABSTRACT
PURPOSE:
To evaluate the diagnostic performance of a novel CT post-processing software that generates subtraction maps of baseline and follow-up CT examinations in the course of myeloma bone lesions. MATERIALS ANDMETHODS:
This study included 61 consecutive myeloma patients who underwent repeated whole-body reduced-dose MDCT at our institution between November 2013 and June 2015. CT subtraction maps classified a progressive disease (PD) vs. stable disease (SD)/remission. Bone subtraction maps (BSMs) only and in combination with 1-mm (BSM+) source images were compared with 5-mm axial/MPR scans.RESULTS:
Haematological response categories at follow-up were complete remission (n = 9), very good partial remission (n = 2), partial remission (n = 17) and SDh (n = 19) vs. PDh (n = 14). Five-millimetre CT scan yielded PD (n = 14) and SD/remission (n = 47) whereas bone subtraction + 1-mm axial scans (BSM+) reading resulted in PD (n = 18) and SD/remission (n = 43). Sensitivity/ specificity/accuracy for 5-mm/1-mm/BSM(alone)/BSM + in "lesion-by-lesion" reading was 89.4 %/98.9 %/98.3 %/ 99.5 %; 69.1 %/96.9 %/72 %/92.1 % and 83.8 %/98.4 %/92.1 %/98.3 %, respectively. The use of BSM+ resulted in a change of response classification in 9.8 % patients (n = 6) from SD to PD.CONCLUSION:
BSM reading is more accurate for monitoring myeloma compared to axial scans whereas BSM+ yields similar results with 1-mm reading (gold standard) but by significantly reduced reading time. KEY POINTS ⢠CT evaluation of myeloma bone disease using a longitudinal bone subtraction post-processing algorithm. ⢠Bone subtraction post-processing algorithm is more accurate for assessment of therapy. ⢠Bone subtraction allowed improved and more efficient detection of myeloma bone lesions. ⢠Post-processing tool demonstrating a change in response classification in 9.8 % patients (all showing PD). ⢠Reading time could be substantially shortened as compared to regular CT assessment.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Pelvic Bones
/
Algorithms
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Image Interpretation, Computer-Assisted
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Whole Body Imaging
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Multidetector Computed Tomography
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Multiple Myeloma
/
Neoplasm Staging
Type of study:
Observational_studies
/
Prognostic_studies
Limits:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
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Male
/
Middle aged
Language:
En
Journal:
Eur Radiol
Journal subject:
RADIOLOGIA
Year:
2017
Document type:
Article
Affiliation country:
Germany