Calcium-based imaging of the spine at dual-layer CT and evaluation of vertebral fractures in multiple myeloma

Purpose: To evaluate the prediction of vertebral fractures in plasma cell dyscrasias using dual-layer CT (DLCT) with quantitative assessment of conventional CT image data (CI), calcium suppressed image data (CaSupp), and calculation of virtual calcium-only (VCa) image data. Material and Methods: Pat...

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Hauptverfasser: Brandelik, Simone Christine (VerfasserIn) , Rahn, Stefanie (VerfasserIn) , Merz, Maximilian (VerfasserIn) , Stiller, Wolfram (VerfasserIn) , Skornitzke, Stephan (VerfasserIn) , Melzig, Claudius (VerfasserIn) , Kauczor, Hans-Ulrich (VerfasserIn) , Weber, Tim (VerfasserIn) , Do, Thuy (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: August-1 2024
In: Cancers
Year: 2024, Jahrgang: 16, Heft: 15
ISSN:2072-6694
DOI:10.3390/cancers16152688
Online-Zugang:Verlag, kostenfrei, Volltext: https://doi.org/10.3390/cancers16152688
Verlag, kostenfrei, Volltext: https://www.mdpi.com/2072-6694/16/15/2688
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Verfasserangaben:Simone C. Brandelik, Stefanie Rahn, Maximilian Merz, Wolfram Stiller, Stephan Skornitzke, Claudius Melzig, Hans-Ulrich Kauczor, Tim F. Weber and Thuy D. Do

MARC

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245 1 0 |a Calcium-based imaging of the spine at dual-layer CT and evaluation of vertebral fractures in multiple myeloma  |c Simone C. Brandelik, Stefanie Rahn, Maximilian Merz, Wolfram Stiller, Stephan Skornitzke, Claudius Melzig, Hans-Ulrich Kauczor, Tim F. Weber and Thuy D. Do 
264 1 |c August-1 2024 
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520 |a Purpose: To evaluate the prediction of vertebral fractures in plasma cell dyscrasias using dual-layer CT (DLCT) with quantitative assessment of conventional CT image data (CI), calcium suppressed image data (CaSupp), and calculation of virtual calcium-only (VCa) image data. Material and Methods: Patients (n = 81) with the diagnosis of a plasma cell dyscrasia and whole-body DLCT at the time of diagnosis and follow-up were retrospectively enrolled. CI, CaSupp25, and CaSupp100 were quantitatively analyzed using regions of interest in the lumbar vertebral bodies and fractured vertebral bodies on baseline or follow-up imaging. VCa were calculated by subtraction (CaSupp100-CaSupp25), delineating bone only. Logistic regression analyses were performed to assess the possibility of imminent spine fractures. Results: In 24 patients, new vertebral fractures were observed in the follow-up imaging. The possibility of new vertebral fractures was significant for baseline assessment of CT numbers in CI, CaSupp25, and VCa (p = 0.01, respectively), with a higher risk for new fractures in the case of lower CT numbers in CI (Odds ratio = [0.969; 0.994]) and VCa (Odds ratio = [0.978; 0.995]) and in the case of higher CT numbers in CaSupp 25 (Odds ratio 1.015 [1.006; 1.026]). Direct model comparisons implied that CT numbers in CaSupp 25 and VCa might show better fracture prediction than those in CI (R2 = 0.18 both vs. 0.15; AICc = 91.95, 91.79 vs. 93.62), suggesting cut-off values for CI at 103 HU (sensitivity: 54.2%; specificity: 82.5; AUC: 0.69), for VCa at 129 HU (sensitivity: 41.7%; specificity: 94.7; AUC: 0.72). Conclusions: Quantitative assessment with CaSupp and calculation of VCa is feasible to predict the vertebral fracture risk in MM patients. DLCT may prove useful in detecting imminent fractures. 
650 4 |a computed tomography 
650 4 |a dual-layer spectral CT 
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650 4 |a multiple myeloma 
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