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Can whole-body low-dose multidetector CT exclude the presence of myeloma bone disease in patients with monoclonal gammopathy of undetermined significance (MGUS)?

Standard

Can whole-body low-dose multidetector CT exclude the presence of myeloma bone disease in patients with monoclonal gammopathy of undetermined significance (MGUS)? / Spira, Daniel; Weisel, Katja; Brodoefel, Harald; Schulze, Maximilian; Kaufmann, Sascha; Horger, Marius.

in: ACAD RADIOL, Jahrgang 19, Nr. 1, 01.2012, S. 89-94.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Spira, D, Weisel, K, Brodoefel, H, Schulze, M, Kaufmann, S & Horger, M 2012, 'Can whole-body low-dose multidetector CT exclude the presence of myeloma bone disease in patients with monoclonal gammopathy of undetermined significance (MGUS)?', ACAD RADIOL, Jg. 19, Nr. 1, S. 89-94. https://doi.org/10.1016/j.acra.2011.09.016

APA

Spira, D., Weisel, K., Brodoefel, H., Schulze, M., Kaufmann, S., & Horger, M. (2012). Can whole-body low-dose multidetector CT exclude the presence of myeloma bone disease in patients with monoclonal gammopathy of undetermined significance (MGUS)? ACAD RADIOL, 19(1), 89-94. https://doi.org/10.1016/j.acra.2011.09.016

Vancouver

Spira D, Weisel K, Brodoefel H, Schulze M, Kaufmann S, Horger M. Can whole-body low-dose multidetector CT exclude the presence of myeloma bone disease in patients with monoclonal gammopathy of undetermined significance (MGUS)? ACAD RADIOL. 2012 Jan;19(1):89-94. https://doi.org/10.1016/j.acra.2011.09.016

Bibtex

@article{d2bed040166f4c04be71316dfc621c29,
title = "Can whole-body low-dose multidetector CT exclude the presence of myeloma bone disease in patients with monoclonal gammopathy of undetermined significance (MGUS)?",
abstract = "RATIONALE AND OBJECTIVES: To determine the benefit of using whole-body low-dose computed tomography (WBLD-CT) in patients with monoclonal gammopathy of undetermined significance (MGUS) for exclusion of multiple myeloma (MM) bone disease.MATERIALS AND METHODS: Seventy-one consecutive patients with confirmed MGUS (as defined by the latest criteria of the International Myeloma Working Group) who underwent WBLD-CT for diagnosis were identified retrospectively by a search of our institution's electronic medical record database (2002-2009). Patients were classified as low-risk or intermediate/high-risk and followed over a ≥2-year period with additional CT imaging and/or laboratory parameters. Presence of osteolysis, medullary, or extramedullary abnormalities compatible with involvement by MM was recorded. A diffuse or focal increase in medullary density to Hounsfield unit (HU) values >20 HU/>0 HU was considered suspicious for bone marrow infiltration if no other causes identifiable.RESULTS: The presence of osteolysis was excluded in all 71 patients with MGUS at initial diagnosis and patients were surveilled for ≥2 years. Lytic changes were observed at follow-up in 1/71 patients that progressed to MM and were detectable via WBLD-CT at an early stage (even before a significant rise in M-protein was recorded). In 3/71 patients with MGUS (4%) suspicious bone marrow attenuation values were measured, disclosing disease progression to smoldering myeloma in another patient and false-positive results in 2/71 patients. Bone marrow attenuation assessment resulted in a specificity and negative predictive value of 97%, respectively. No significant difference with respect to bone marrow attenuation was observed in patients with low-risk MGUS versus intermediate- to high-risk MGUS. One of 71 patients showed serologic disease progression to active MM without bone abnormalities detectable.CONCLUSION: WBLD-CT reliably excludes findings compatible with myeloma in MGUS and thereby complements hematologic laboratory analysis.",
keywords = "Adult, Aged, Aged, 80 and over, Bone Neoplasms, Diagnosis, Differential, Humans, Middle Aged, Monoclonal Gammopathy of Undetermined Significance, Multiple Myeloma, Radiation Dosage, Reproducibility of Results, Sensitivity and Specificity, Tomography, X-Ray Computed, Whole Body Imaging, Journal Article",
author = "Daniel Spira and Katja Weisel and Harald Brodoefel and Maximilian Schulze and Sascha Kaufmann and Marius Horger",
note = "Copyright {\textcopyright} 2012 AUR. Published by Elsevier Inc. All rights reserved.",
year = "2012",
month = jan,
doi = "10.1016/j.acra.2011.09.016",
language = "English",
volume = "19",
pages = "89--94",
journal = "ACAD RADIOL",
issn = "1076-6332",
publisher = "Elsevier USA",
number = "1",

}

RIS

TY - JOUR

T1 - Can whole-body low-dose multidetector CT exclude the presence of myeloma bone disease in patients with monoclonal gammopathy of undetermined significance (MGUS)?

AU - Spira, Daniel

AU - Weisel, Katja

AU - Brodoefel, Harald

AU - Schulze, Maximilian

AU - Kaufmann, Sascha

AU - Horger, Marius

N1 - Copyright © 2012 AUR. Published by Elsevier Inc. All rights reserved.

PY - 2012/1

Y1 - 2012/1

N2 - RATIONALE AND OBJECTIVES: To determine the benefit of using whole-body low-dose computed tomography (WBLD-CT) in patients with monoclonal gammopathy of undetermined significance (MGUS) for exclusion of multiple myeloma (MM) bone disease.MATERIALS AND METHODS: Seventy-one consecutive patients with confirmed MGUS (as defined by the latest criteria of the International Myeloma Working Group) who underwent WBLD-CT for diagnosis were identified retrospectively by a search of our institution's electronic medical record database (2002-2009). Patients were classified as low-risk or intermediate/high-risk and followed over a ≥2-year period with additional CT imaging and/or laboratory parameters. Presence of osteolysis, medullary, or extramedullary abnormalities compatible with involvement by MM was recorded. A diffuse or focal increase in medullary density to Hounsfield unit (HU) values >20 HU/>0 HU was considered suspicious for bone marrow infiltration if no other causes identifiable.RESULTS: The presence of osteolysis was excluded in all 71 patients with MGUS at initial diagnosis and patients were surveilled for ≥2 years. Lytic changes were observed at follow-up in 1/71 patients that progressed to MM and were detectable via WBLD-CT at an early stage (even before a significant rise in M-protein was recorded). In 3/71 patients with MGUS (4%) suspicious bone marrow attenuation values were measured, disclosing disease progression to smoldering myeloma in another patient and false-positive results in 2/71 patients. Bone marrow attenuation assessment resulted in a specificity and negative predictive value of 97%, respectively. No significant difference with respect to bone marrow attenuation was observed in patients with low-risk MGUS versus intermediate- to high-risk MGUS. One of 71 patients showed serologic disease progression to active MM without bone abnormalities detectable.CONCLUSION: WBLD-CT reliably excludes findings compatible with myeloma in MGUS and thereby complements hematologic laboratory analysis.

AB - RATIONALE AND OBJECTIVES: To determine the benefit of using whole-body low-dose computed tomography (WBLD-CT) in patients with monoclonal gammopathy of undetermined significance (MGUS) for exclusion of multiple myeloma (MM) bone disease.MATERIALS AND METHODS: Seventy-one consecutive patients with confirmed MGUS (as defined by the latest criteria of the International Myeloma Working Group) who underwent WBLD-CT for diagnosis were identified retrospectively by a search of our institution's electronic medical record database (2002-2009). Patients were classified as low-risk or intermediate/high-risk and followed over a ≥2-year period with additional CT imaging and/or laboratory parameters. Presence of osteolysis, medullary, or extramedullary abnormalities compatible with involvement by MM was recorded. A diffuse or focal increase in medullary density to Hounsfield unit (HU) values >20 HU/>0 HU was considered suspicious for bone marrow infiltration if no other causes identifiable.RESULTS: The presence of osteolysis was excluded in all 71 patients with MGUS at initial diagnosis and patients were surveilled for ≥2 years. Lytic changes were observed at follow-up in 1/71 patients that progressed to MM and were detectable via WBLD-CT at an early stage (even before a significant rise in M-protein was recorded). In 3/71 patients with MGUS (4%) suspicious bone marrow attenuation values were measured, disclosing disease progression to smoldering myeloma in another patient and false-positive results in 2/71 patients. Bone marrow attenuation assessment resulted in a specificity and negative predictive value of 97%, respectively. No significant difference with respect to bone marrow attenuation was observed in patients with low-risk MGUS versus intermediate- to high-risk MGUS. One of 71 patients showed serologic disease progression to active MM without bone abnormalities detectable.CONCLUSION: WBLD-CT reliably excludes findings compatible with myeloma in MGUS and thereby complements hematologic laboratory analysis.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Bone Neoplasms

KW - Diagnosis, Differential

KW - Humans

KW - Middle Aged

KW - Monoclonal Gammopathy of Undetermined Significance

KW - Multiple Myeloma

KW - Radiation Dosage

KW - Reproducibility of Results

KW - Sensitivity and Specificity

KW - Tomography, X-Ray Computed

KW - Whole Body Imaging

KW - Journal Article

U2 - 10.1016/j.acra.2011.09.016

DO - 10.1016/j.acra.2011.09.016

M3 - SCORING: Journal article

C2 - 22142681

VL - 19

SP - 89

EP - 94

JO - ACAD RADIOL

JF - ACAD RADIOL

SN - 1076-6332

IS - 1

ER -