Open Access

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

Xing Xiong
Xing Xiong
, 
Rong Hong
Rong Hong
, 
Xu Fan
Xu Fan
, 
Zhengmei Hao
Zhengmei Hao
, 
Xiaohui Zhang
Xiaohui Zhang
, 
Yu Zhang
Yu Zhang
 and 
Chunhong Hu
Chunhong Hu
   | Jan 06, 2024
Radiology and Oncology's Cover Image
About this article
Previous Article
Next Article
Cite
Article Category: Research Article
Published Online: Jan 06, 2024
Page range: 43 - 50
Received: Aug 18, 2023
Accepted: Oct 31, 2023
DOI: https://doi.org/10.2478/raon-2024-0003
Keywords
© 2024 Xing Xiong et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.

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

L1 L2 L3 L4 L5 Averaged L1−L5
ADC 554.12±177.42 520.02±171.74 546.19±179.75 523.20±175.14 524.3±173.17 536.30±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 75 2.03±15.39 3.29±16.53 2.12±18.3 −2.58±14.9 1.42±14.54 2.08±13.26
CaSupp 85 18.63±16.60 19.22±17.75 17.45±18.93 12.93±16.52 18.55±15.37 17.61±14.59
CaSupp 95 32.46±19.15 32.46±20.12 30.25±20.75 25.98±19.16 33.00±17.41 30.59±17.20

Patient characteristics

Characteristics n
Age* 57.9 ± 8.1
Sex#
Males 26 (55.3%)
Females 21 (44.7%)
Myeloma subtypes#
IgG 32 (68.1%)
IgA 10 (21.3%)
Light chain 5 (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#
HRC 26 (55.3%)
SRC 21 (44.7%)
eISSN:
1581-3207
Language:
English
Publication timeframe:
4 times per year
Journal Subjects:
Medicine, Clinical Medicine, Internal Medicine, Haematology, Oncology, Radiology
Journal RSS Feed