Recommendations for acquisition, interpretation and reporting of whole body low dose CT in patients with multiple myeloma and other plasma cell disorders: a report of the IMWG Bone Working Group

Whole-body low-dose computed tomography (WBLDCT) is recommended as a first-line imaging modality for bone disease assessment in multiple myeloma patients. ​ It offers higher sensitivity compared to conventional radiographs for detecting osteolytic lesions. ​ Proper imaging parameters, such as thin-slice coverage of the whole skeleton and specific tube voltage and time-current product, along with patient positioning, are crucial for obtaining diagnostic quality images with low radiation dose. ​ WBLDCT can detect osteolytic lesions, cortical thinning, and extraosseous soft tissue masses. ​ It is also useful for evaluating medullary infiltration, red marrow reconversion, and fracture risk, particularly vertebral compression fractures. ​ Structured reporting of imaging findings is encouraged to facilitate communication between specialists and aid in timely patient management decisions. ​ WBLDCT is a valuable tool for assessing bone disease in multiple myeloma patients, offering wide availability, simplicity, and patient-friendliness. ​

Important Points:

1. WBLDCT is recommended as a first-line imaging modality for bone disease assessment in multiple myeloma patients. ​
2. WBLDCT has higher sensitivity than conventional radiographs for detecting osteolytic lesions. ​
3. Proper imaging parameters and patient positioning are crucial for obtaining diagnostic quality images with low radiation dose. ​
4. WBLDCT can detect osteolytic lesions, cortical thinning, and extraosseous soft tissue masses. ​
5. It is useful for evaluating medullary infiltration, red marrow reconversion, and fracture risk, particularly vertebral compression fractures. ​
6. Structured reporting of imaging findings is encouraged for effective communication and decision-making. ​
7. WBLDCT is widely available, simple to perform, and patient-friendly.
8. It offers advantages such as wide coverage, low radiation dose, and short scanning time. ​
9. Technical parameters include specific tube voltage and time-current product, collimation, and reconstruction algorithms. ​
10. Patient positioning should include the humeri in the field of view without degrading image quality. ​

Authors:

Lia A. Moulopoulos, Vassilis Koutoulidis, Jens Hillengass, Elena Zamagni, Jesus D. Aquerreta, Charles L. Roche, Suzanne Lentzsch, Philippe Moreau, Michele Cavo, Jesus San Miguel, Meletios A. Dimopoulos, S. Vincent Rajkumar, Brian G. M. Durie, Evangelos Terpos & Stefan Delorme

Citation:

Moulopoulos et al. Blood Cancer Journal (2018) 8:95
DOI 10.1038/s41408-018-0124-1