Miyuki Takasu, Presenter: Nothing to Disclose

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

Miho Ishikawa, Abstract Co-Author: Nothing to Disclose

Shuji Date, Abstract Co-Author: Nothing to Disclose

Akira Sakai, Abstract Co-Author: Nothing to Disclose

Kazuo Awai MD, Abstract Co-Author: Research grant, Toshiba Corporation Research grant, Hitachi, Ltd Research grant, Bayer AG

Mari Matsuda MD, Abstract Co-Author: Nothing to Disclose

Hideki Asaoku, Abstract Co-Author: Nothing to Disclose

Computed tomography (CT) is used for the diagnosis and management of multiple myeloma patients to better clarify the extent of bone destruction and to evaluate the osteopenia. However, no previous reports have assessed changes in trabecular bones during the course of the disease. The purpose of this study was to evaluate differences in spinal microarchitecture among patients with different clinical stages of multiple myeloma.

We examined the spinal microarchitecture in patients with asymptomatic myeloma (n=35), symptomatic myeloma (n=29), and in 155 sex- and age-matched normal controls by using a 64-detector CT (GE). The patients were 27 men and 37 women (mean age 71.1 and 69.2 years, respectively). Using 64-detector CT data and a 3D image analysis system (TRI/3D-BON; RATOC, Japan), we calculated trabecular parameters of the third lumbar vertebrae including the trabecular bone volume fraction, -thickness (TbT), -number, -separation, and -width, the fractal dimension, Euler’s number, degree of anisotropy (DA), and the structure model index. We compared the trabecular parameters in the three study groups by one-way analysis of variance using the Scheffe post hoc test. Differences were considered significant at p<0.05.

Among the three groups, TbT (737.4 ± 100 μm, p<0.01) was significantly elevated in asymptomatic myeloma (Fig. 1) compared to controls in males, while no significant difference was detected between controls and symptomatic myeloma. DA (male, 1.56 ± 0.25; female, 1.59 ± 0.25, p<0.01) was significantly elevated in asymptomatic myeloma compared to controls in both genders. Among male patients, DA in symptomatic myeloma (1.36 ± 0.16, p<0.01) was lower than in asymptomatic myeloma, while among female patients, DA in symptomatic myeloma (1.58 ± 0.25) was similar to that in asymptomatic myeloma.

In multiple myeloma, trabecular bones were thickened and oriented along one direction in the asymptomatic stage; their thickness and directionality were reduced during the progression to symptomatic myeloma in male patients. In females, no trabecular parameters could differentiate asymptomatic- from symptomatic myeloma.

Analysis of the trabecular microstructure of the lumbar spine is useful to elucidate changes in the course of myeloma and may help to predict vertebral fractures in the disease.

Takasu, M, Kiguchi, M, Ishikawa, M, Date, S, Sakai, A, Awai, K, Matsuda, M, Asaoku, H, Transient Thickening of Trabecular Bone in Patients with Multiple Myeloma Detected by Microstructure Analysis of Lumbar Vertebrae Using Multidetector Computed Tomography.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11006885.html