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Quantitative assessment of bone marrow infiltration and characterization of tumor burden using dual-layer spectral CT in patients with multiple myeloma Cover

Quantitative assessment of bone marrow infiltration and characterization of tumor burden using dual-layer spectral CT in patients with multiple myeloma

Radiology and Oncology
Volume 58 (2024): Issue 1 (March 2024)
By: Xing Xiong,  Rong Hong,  Xu Fan,  Zhengmei Hao,  Xiaohui Zhang,  Yu Zhang and  Chunhong Hu  
Open Access
|Jan 2024

Figures & Tables

FIGURE 1.

An example of bone marrow (BM) segmentation in multiple myeloma (MM) patient. An oval regions of interests (ROIs) of 100 mm2 was drawn at the central slice of sagittal vertebral bodies L1−L5 in different virtual calcium subtraction (VNCa) images and the corresponding location was manually displayed on the axial apparent diffusion coefficient (ADC) map. (A) calcium-suppressed (CaSupp) index 25, (B) CaSupp index 55, (C) CaSupp index 85, (D) CaSupp index95, (E) magnification of (C), (F) ADC map.
An example of bone marrow (BM) segmentation in multiple myeloma (MM) patient. An oval regions of interests (ROIs) of 100 mm2 was drawn at the central slice of sagittal vertebral bodies L1−L5 in different virtual calcium subtraction (VNCa) images and the corresponding location was manually displayed on the axial apparent diffusion coefficient (ADC) map. (A) calcium-suppressed (CaSupp) index 25, (B) CaSupp index 55, (C) CaSupp index 85, (D) CaSupp index95, (E) magnification of (C), (F) ADC map.

FIGURE 2.

Flow chart of patients’ selection.DLCT = low-dose dual-layer spectral CT; MM = multiple myeloma
Flow chart of patients’ selection.DLCT = low-dose dual-layer spectral CT; MM = multiple myeloma

FIGURE 3.

Heat map of Pearson’s correlation r and p value between CT numbers (combined different calcium-suppressed [CaSupp] indices with measured locations) and apparent diffusion coefficient (ADC) values.
Heat map of Pearson’s correlation r and p value between CT numbers (combined different calcium-suppressed [CaSupp] indices with measured locations) and apparent diffusion coefficient (ADC) values.

FIGURE 4.

Bivariate correlation between CT number (averaged L1−L5 at calcium-suppressed [CaSupp] index 85) and plasma cell infiltration rate (PCIR) confirmed by bone marrow biopsy. The Pearson’s r yields 0.835 with p value < 0.001.
Bivariate correlation between CT number (averaged L1−L5 at calcium-suppressed [CaSupp] index 85) and plasma cell infiltration rate (PCIR) confirmed by bone marrow biopsy. The Pearson’s r yields 0.835 with p value < 0.001.

FIGURE 5.

Receiver operating characteristic curves for CT number (averaged L1−L5 at calcium-suppressed [CaSupp] index 85) to predict “high serum-free light chains (SFLC) ratio” (A) and “cytogenetic status” (B).
Receiver operating characteristic curves for CT number (averaged L1−L5 at calcium-suppressed [CaSupp] index 85) to predict “high serum-free light chains (SFLC) ratio” (A) and “cytogenetic status” (B).

Means and standard deviations of MRI apparent diffusion coefficient (ADC) and CT numbers in virtual calcium subtraction (VNCa) images for all measured locations

L1L2L3L4L5Averaged L1−L5
ADC554.12±177.42520.02±171.74546.19±179.75523.20±175.14524.3±173.17536.30±163.93
CaSupp 25−236.58±77.07−227.60±73.00−217.83±83.35−225.40±82.36−244.67±79.27−221.19±78.89
CaSupp 35−138.15±46.58−131.15±43.86−127.11±51.4−133.38±49.30−143.10±48.23−128.84±47.37
CaSupp 45−82.04±30.19−77.33±28.86−75.38±34.45−81.01±31.32−85.24±31.31−76.42±30.10
CaSupp 55−45.12±20.87−41.925±20.70−41.32±24.80−46.57±20.95−47.08±21.44−41.92±19.91
CaSupp 65−18.50±16.35−16.38±17.05−16.79±19.89−21.71±15.83−19.71±16.14−17.07±14.58
CaSupp 752.03±15.393.29±16.532.12±18.3−2.58±14.91.42±14.542.08±13.26
CaSupp 8518.63±16.6019.22±17.7517.45±18.9312.93±16.5218.55±15.3717.61±14.59
CaSupp 9532.46±19.1532.46±20.1230.25±20.7525.98±19.1633.00±17.4130.59±17.20

Patient characteristics

Characteristicsn
Age*57.9 ± 8.1
Sex#
Males26 (55.3%)
Females21 (44.7%)
Myeloma subtypes#
IgG32 (68.1%)
IgA10 (21.3%)
Light chain5 (10.6%)
Plasma cell infiltration ratio obtained from the wing of ilium*0.54 ± 0.30
Kappa/lambda SFLC ratio#
High (< 0.01 or > 100)27 (57.4%)
Low (0.01−100)20 (42.6%)
Cytogenetic status#
HRC26 (55.3%)
SRC21 (44.7%)
DOI: https://doi.org/10.2478/raon-2024-0003 | Journal eISSN: 1581-3207 | Journal ISSN: 1318-2099
Journal RSS Feed
Language: English
Page range: 43 - 50
Submitted on: Aug 18, 2023
|
Accepted on: Oct 31, 2023
|
Published on: Jan 6, 2024
Published by: Association of Radiology and Oncology
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year
Keywords:
bone marrow,
tumor burden,
virtual non-calcium,
dual energy CT,
multiple myeloma
Related subjects:
Medicine,
Clinical medicine,
Internal medicine,
Haematology, oncology,
Radiology

© 2024 Xing Xiong, Rong Hong, Xu Fan, Zhengmei Hao, Xiaohui Zhang, Yu Zhang, Chunhong Hu, published by Association of Radiology and Oncology
This work is licensed under the Creative Commons Attribution 4.0 License.

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