Miyuki Takasu, Presenter: Nothing to Disclose

Masao Kiguchi RT, Abstract Co-Author: Nothing to Disclose

Shuji Date, Abstract Co-Author: Nothing to Disclose

Hiroshi Fukuda MD, PhD, Abstract Co-Author: Nothing to Disclose

Akira Sakai, Abstract Co-Author: Nothing to Disclose

Kazuo Awai MD, Abstract Co-Author: Nothing to Disclose

Hideki Asaoku, Abstract Co-Author: Nothing to Disclose

Akihisa Tamura MD, Abstract Co-Author: Nothing to Disclose

In patients with multiple myeloma, bone destruction due to osteoclastic activity of myeloma cells may progress before multidetector CT (MDCT) can detect pathological changes such as osteopenia and osteolysis. The involvement by tumor cells of the vertebral trabecular network must be detected before the manifestation of pathologic fracture. We evaluated the usefulness of trabecular analysis of the lumbar spine by MDCT to differentiate myeloma patients without spinal fractures from normal subjects.

The spinal microarchitecture was examined by 64-detector CT in 29 patients with multiple myeloma and 51 sex- and age-matched normal controls. The patients were 13 males and 16 females (mean age 71.1 and 69.2 years, respectively); the disease was stage 1 in 13, stage 2 in 5, and stage 3 in 11 patients. Using MDCT data we calculated trabecular parameters of L3 vertebrae with a 3D image analysis system (TRI/3D-BON; RATOC, Japan). These included the trabecular bone volume fraction (BV/TV), -thickness (TbT), -number (TbN), -separation (TbS), fractal dimension (FD), Euler’s number (EN), degree of anisotropy (DA), and the structure model index (SMI). To identify potential predictors in myeloma patients, we performed univariable analysis for parameters by analysis of variance. A multivariable generalized linear model was constructed to identify parameters that differentiated between patients and controls. Parameters with p < 0.05 were included in the multivariable model.

TbT, DA, EN, and TbS were included in the multivariable generalized linear model. TbT of male- (703.7 ± 46.7 μm, p=0.04) and DA of female patients (1.87 ± 0.1, p=0.009) had a statistically significant effect on the differentiation between patients and controls.

There were significant differences in the spinal microarchitecture between normal subjects and myeloma patients without pathologic fracture. Independent predictors of multiple myeloma were TbT in male- and DA in female patients.

Analysis of the trabecular microstructure of the lumbar spine is useful to differentiate myeloma patients from normal subjects and may help to predict vertebral fractures in myeloma patients.

Takasu, M, Kiguchi, M, Date, S, Fukuda, H, Sakai, A, Awai, K, Asaoku, H, Tamura, A, Microstructure Analysis of Lumbar Trabecular Bones in Patients with Multiple Myeloma Using Multidetector CT to Detect Subclinical Bone Lesions.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9003208.html