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Eur Radiol. 2020 Feb 11. doi: 10.1007/s00330-019-06631-9. [Epub ahead of print]

Rapid study assessment in follow-up whole-body computed tomography in patients with multiple myeloma using a dedicated bone subtraction software.

Author information

1
Department of Radiology and Nuclear Medicine, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany. Malte.Sieren@uksh.de.
2
Department of Radiology and Nuclear Medicine, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany.
3
Fraunhofer Institute for Digital Medicine MEVIS, Lübeck, Germany.
4
Department of Haematology and Oncology, UKSH, Campus Lübeck, Lübeck, Germany.

Abstract

OBJECTIVES:

The diagnostic reading of follow-up low-dose whole-body computed tomography (WBCT) examinations in patients with multiple myeloma (MM) is a demanding process. This study aimed to evaluate the diagnostic accuracy and benefit of a novel software program providing rapid-subtraction maps for bone lesion change detection.

METHODS:

Sixty patients (66 years ± 10 years) receiving 120 WBCT examinations for follow-up evaluation of MM bone disease were identified from our imaging archive. The median follow-up time was 292 days (range 200-641 days). Subtraction maps were calculated from 2-mm CT images using a nonlinear deformation algorithm. Reading time, correctly assessed lesions, and disease classification were compared to a standard reading software program. De novo clinical reading by a senior radiologist served as the reference standard. Statistics included Wilcoxon rank-sum test, Cohen's kappa coefficient, and calculation of sensitivity, specificity, positive/negative predictive value, and accuracy.

RESULTS:

Calculation time for subtraction maps was 84 s ± 24 s. Both readers reported exams faster using subtraction maps (reader A, 438 s ± 133 s; reader B, 1049 s ± 438 s) compared to PACS software (reader A, 534 s ± 156 s; reader B, 1486 s ± 587 s; p < 0.01). The course of disease was correctly classified by both methods in all patients. Sensitivity for lesion detection in subtraction maps/conventional reading was 92%/80% for reader A and 88%/76% for reader B. Specificity was 98%/100% for reader A and 95%/96% for reader B.

CONCLUSION:

A software program for the rapid-subtraction map calculation of follow-up WBCT scans has been successfully tested and seems suited for application in clinical routine. Subtraction maps significantly facilitated reading of WBCTs by reducing reading time and increasing sensitivity.

KEY POINTS:

• A novel algorithm has been successfully applied to generate motion-corrected bone subtraction maps of whole-body low-dose CT scans in less than 2 min. • Motion-corrected bone subtraction maps significantly facilitate the reading of follow-up whole-body low-dose CT scans in multiple myeloma by reducing reading time and increasing sensitivity.

KEYWORDS:

Algorithms; Multiple myeloma; Subtraction technique; Whole-body imaging; X-ray computed tomography

PMID:
32048038
DOI:
10.1007/s00330-019-06631-9

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