Multiple Myeloma and Dual-Energy CT: Diagnostic Accuracy of Virtual Noncalcium Technique for Detection of Bone Marrow Infiltration of the Spine and Pelvis

Kosmala, Aleksander; Weng, Andreas Max; Heidemeier, Anke; Krauß, Bernhard; Knop, Stefan; Bley, Thorsten Alexander; Petritsch, Bernhard

doi:10.1148/radiol.2017170281

Cited by 115 publications

(92 citation statements)

References 35 publications

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“…Computed tomography is particularly useful for further characterization of tumors with mineralized matrix and of sclerotic tumors. Most recently the application of dual energy CT virtual non-calcium algorithms has proven to be a valuable tool in the assessment of MBD lesions and disease load [33][34][35] as well as in identifying focal biopsy targets [36]. Moreover, CT is also useful for further characterization of tumors in the cortex, paracortical, and periosteal locations.…”

Section: Cross-sectional Imaging: Mri and Ctmentioning

confidence: 99%

State-of-the-art imaging for diagnosis of metastatic bone disease

Isaac

Dalili

et al. 2020

Radiologe

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Table 1 Epidemiological indicators: total number of cancer cases in Germany in 2013 (modified according to [21]) New cases Women Men Death Women Men Absolute number 229,920 252,550 Absolute number 101,779 121,314 Mean age at diagnosis 67.2 68.3 Mean age at diagnosis 74.3 73.3 Raw rate 558.4 639.9 Raw rate 247.2 307.7 Age-standardized rate a 351.2 434.1 Age-standardized rate a 126.7 196.5 Current trend +0.8%-0.5% Current trend-0.7%-1.2% Age-standardized rate a 327.9 447.6 Age-standardized rate a 126.8 211.8 Prognosis for 2020 (absolute number) 244,100 274,900 Prognosis for 2020 (absolute number)-0.8%-1.5%

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Section: Cross-sectional Imaging: Mri and Ctmentioning

confidence: 99%

State-of-the-art imaging for diagnosis of metastatic bone disease

Isaac

Dalili

et al. 2020

Radiologe

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“…7). Mit deren Hilfe konnte gezeigt werden, dass auch ein nicht osteolytischer Knochenmarkbefall im Achsenskelett CT-grafisch detektierbar ist [53,54]. Die Technik kann außerdem dazu verwendet werden, gezielt fokale Knochenläsionen zu biopsieren, die im her- kömmlichem CT okkult sind [55].…”

Section: Zukünftige Entwicklungenunclassified

Bildgebende Diagnostik des Multiplen Myeloms

2020

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Hintergrund Das Multiple Myelom ist eine maligne hämatologische Erkrankung, die sich durch die Proliferation von monoklonalen Plasmazellen vor allem im Knochenmark auszeichnet. Die Bildgebung spielt zur Diagnosestellung und Verlaufsbeurteilung eine wichtige Rolle. Methode Dieser Übersichtsartikel informiert über das Krankheitsbild des Multiplen Myeloms samt Vorstufen und beschreibt die zur Verfügung stehenden bildgebenden Untersuchungstechniken. Diese werden samt Vor- und Nachteilen sowie möglichen prognostischen und therapeutischen Implikationen vor dem Hintergrund der aktuellen Literatur vorgestellt. Ergebnisse und Schlussfolgerung Der konventionelle Röntgenstatus ist beim Multiplen Myelom mittlerweile vollständig von Schnittbildtechniken ersetzt worden. Die breit verfügbare Ganzkörper-Computertomografie wird routinemäßig verwendet, um Osteolysen nachzuweisen. Die Magnetresonanztomografie hat die höchste Sensitivität zur Detektion von Knochenmarkbefall und wird insbesondere bei den Vorstufen des symptomatischen Multiplen Myeloms empfohlen. Die Positronen-Emissions-Tomografie vereint morphologische und funktionelle Bildgebung. Sie kommt vor allem bei der Verlaufsbeurteilung und Evaluation von Therapieansprechen zum Einsatz. Kernaussagen:

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“…The use of a three-material decomposition model allows for the creation of VNCa images by subtracting calcium from CT data. To date, few studies have reported on the use of this technique to directly depict (a) trauma-associated bone marrow edema in the extremities (9,10) or spine (11)(12)(13)(14)22,23) or (b) malignant bone marrow infiltration (15,16,24). However, to our knowledge, this is the first and largest prospective study to address the bone marrow edema associated with inflammatory rheumatic disorders when using dual-energy CT (25,26).…”

Section: Quantitative Analysis Of Bone Marrow Ct Numbersmentioning

confidence: 99%

“…However, the inability of conventional single-energy CT to depict bone marrow edema, which is regarded as the early stage of active inflammation, significantly limits its clinical utility (15,27). More recently, it has also been documented that dual-energy CT with the addition of color-coded VNCa images to standard CT images could significantly improve visual sensitivity of readers in the detection of bone marrow lesions, from 69.6% to 91.3% (16). Results from our study support the hypothesis that dual-energy CT with reconstruction of VNCa images has enabled both qualitative (visual) and quantitative analysis of bone marrow edema of sacroiliac joints in study participants with axSpA, with a precision comparable to that of MRI.…”

Section: Disclosures Of Conflicts Ofmentioning

confidence: 99%

Axial Spondyloarthritis: Dual-Energy Virtual Noncalcium CT in the Detection of Bone Marrow Edema in the Sacroiliac Joints

Zhang

Shi

et al. 2019

Radiology

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I n the management of symptomatic axial spondyloarthritis (axSpA), it is important to accurately monitor current disease activity and the extent of structural damage (1). Recent European League Against Rheumatism recommendations on the use of MRI in patients with axSpA show that this imaging modality should be considered for use in the detection of both subchondral bone marrow edema and structural lesions (2-4). Although MRI is especially capable of directly depicting bone marrow edema not detected with other imaging modalities, it is more time consuming and expensive than would be reasonable for routine use (5-7). Although conventional CT is generally regarded as a more reliable method with which to detect structural sacroiliac joint lesions, such as minute erosions, and although it is relatively affordable, highly available, and requires shorter examination times than MRI, it is not widely used because it cannot be used to assess bone marrow edema (2,8). Dual-energy CT is an imaging technique that enables detection of traumatic bone marrow edema (9-14) and plasma cell infiltration of bone marrow (15,16) with high sensitivity and specificity if the patients were examined with a dual-energy mode. Dual-energy CT acquires two CT data sets at different energy levels simultaneously, and it can subsequently quantify and remove the individual chemical elements, like calcium, from those data sets. Postprocessing software is then used to remove calcium in trabecular bone by using the virtual noncalcium subtraction process, thus creating virtual noncalcium (VNCa) images (9-12). Increased water content (edema) or cellular components (multiple myeloma or bone metastases) in the bone marrow can be seen on VNCa images. We hypothesized that dual-energy CT with visual analysis of color-coded images and quantitative regionof-interest (ROI)-based density measurements could enable detection of sacroiliac joint bone marrow edema in participants with axSpA, with precision comparable to that of MRI. Thus, the purpose of our study was to determine the diagnostic performance of a dual-energy CT VNCa technique in the detection and depiction of the

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Multiple Myeloma and Dual-Energy CT: Diagnostic Accuracy of Virtual Noncalcium Technique for Detection of Bone Marrow Infiltration of the Spine and Pelvis

Cited by 115 publications

References 35 publications

State-of-the-art imaging for diagnosis of metastatic bone disease

State-of-the-art imaging for diagnosis of metastatic bone disease

Bildgebende Diagnostik des Multiplen Myeloms

Axial Spondyloarthritis: Dual-Energy Virtual Noncalcium CT in the Detection of Bone Marrow Edema in the Sacroiliac Joints

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