Whole-body low-dose CT recognizes two distinct patterns of lytic lesions in multiple myeloma patients with different disease metabolism at PET/MRI.

ABSTRACT: We evaluated differences in density and ¹⁸F-FDG PET/MRI features of lytic bone lesions (LBLs) identified by whole-body low-dose CT (WB-LDCT) in patients affected by newly diagnosed multiple myeloma (MM). In 18 MM patients, 135 unequivocal LBLs identified by WB-LDCT were characterized for inner density (negative or positive Hounsfield unit (HU)), where negative density (HU?18F-FDG PET/DWI-MRI, registering DWI signal with ADC and SUV max values. According to HU, 35 lesions had a negative density (-?56.94?±?31.87 HU) while 100 lesions presented positive density (44.87?±?23.89 HU). In seven patients, only positive HU LBLs were demonstrated whereas in eight patients, both positive and negative HU LBLs were detected. Intriguingly, in three patients (16%), only negative HU LBLs were shown. At ¹⁸F-FDG PET/DWI-MRI analysis, negative HU LBLs presented low ADC values (360.69?±?154.38?×?10^-6 mm²/s) and low SUV max values (1.69?±?0.56), consistent with fatty marrow, whereas positive HU LBLs showed an infiltrative pattern, characterized by higher ADC (mean 868.46?±?207.67?×?10^-6 mm²/s) and SUV max (mean 5.04?±?1.94) values. Surprisingly, histology of negative HU LBLs documented infiltration by neoplastic plasma cells scattered among adipocytes. In conclusion, two different patterns of LBLs were detected by WB-LDCT in MM patients. Both types of lesions were indicative for active disease, although only positive HU LBL were captured by ¹⁸F-FDG PET/DWI-MRI imaging, indicating that WB-LDCT adds specific information.

SUBMITTER: Zambello R 

PROVIDER: S-EPMC6373185 | biostudies-literature | 2019 Mar

REPOSITORIES: biostudies-literature