Whole-Body CT Influenced the Management of Myeloma and Precursor Diseases

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The use of low-dose WBCT in multiple myeloma provided important information that helped guide patient management in 97% of the cases that were reviewed.
The use of low-dose WBCT in multiple myeloma provided important information that helped guide patient management in 97% of the cases that were reviewed.

Low-dose whole-body computed tomography (WBCT) provided critical information for disease monitoring of individuals with multiple myeloma and its precursor diseases and helped improve patient management, according to the results of a study published in Skeletal Radiology.1

A group of 116 patients underwent WBCT to assess myeloma or monitor one of its precursor diseases, including monoclonal gammopathy of undetermined significance (MGUS) or smoldering myeloma. Images were reviewed for presence or absence of bone disease.

Medical records and follow-up imaging studies were reviewed to assess the influence of WBCT on patient management. A change in management might include a modification in staging from MGUS or smoldering myeloma to multiple myeloma secondary to myeloma-related bone disease; worsening bone disease; impending fracture or a fracture requiring intervention; or detection of another neoplasm.

In all, WBCT led to a change in management in approximately 1 in 4 patients (28%). Among those patients, 17 were upgraded from a precursor disease to myeloma-related bone disease and 13 patients had myeloma progression. In addition, one patient was diagnosed with hepatocellular carcinoma, and one patient had a rib lesion that required intervention.

In more than half (56%) of patients, WBCT was performed for surveillance of precursor diseases or stable, treated myeloma — and no new lesions were detected. According to the researchers, this provided “reassurance to the hematologist with regard to disease status and management.”

Finally, in 13% of patients, WBCT was used as a new baseline before the patient underwent a change in therapy.

“In our study, low-dose WBCT was able to provide important information on patient management in 97% of cases,” the researchers wrote.

Reference

  1. Simeone FJ, Harvey JP, Yee AJ, et al. Value of low-dose whole-body CT in the management of patients with multiple myeloma and precursor states [published online September 14, 2018]. Skeletal Radiol. doi: 10.1007/s00256-018-3066-6

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