Whole-Body 64-Slice Multidetector Computed Tomography (MDCT) Identifies High-Risk Myeloma

Background: In Multiple Myeloma (MM) the individuation of bone lesions at baseline is mandatory because the detection of cortical damage reflects prognostic implications. Conventional Radiography (CR) shows osteolytic bone lesions only when the cortical bone damage is more than 30%. Whole-body 64-slice multidetector computed tomography (MDCT) has recently been employed for detecting early osteolytic disease. Patients and Methods: Twenty-height patients with Asymptomatic MM according to IMWG criteria underwent a 64 MDCT. Results: In our experience MDCT revealed osteolysis in 14/28 patients with normal skeletal survey and in 6 patients with normal Magnetic Resonance Imaging (MRI). Patients with radiological evidence of bone disease on MDCT were at high risk of progression with a median time to progression of 5 months (range 1 - 26 months) in comparison with patients without radiological evidence of bone disease who, conversely, showed a median time to progression of 20 months (range 8 - 40 months) (P = 0.0001). Conclusions: MDCT is able to identify MM patients with a high risk of progression, who might benefit from early therapy.