[The value of chest computerized tomography in evaluation of bone disease and clinical prognosis of multiple myeloma].

OBJECTIVE:To assess the status and severity of bone disease in patients with multiple myeloma (MM) by using chest computerized tomography (CT) and the relationship between clinical prognostic parameters and bone disease. METHODS:All 46 newly diagnosed MM in-patients received both imaging tests of chest CT and plain X ray. An experienced radiologist reviewed all the imaging data. Clinical laboratory parameters, stages of Durie-Salmon (DS) and International Staging System (ISS) were evaluated. Five cytogenetic abnormalities of bone marrow myeloma cells were tested by fluorescence in situ hybridization (FISH). RESULTS:The sensitivity of CT and X ray to determine pathological fractures was comparable, the positive rates of which were 41.3% (19/46) and 30.4% (14/46) respectively (P = 0.29). Nevertheless, the positive rate of osteolytic lesions ascertained by CT was significantly higher than that by X ray (P < 0.001), 60.9% (28/46) vs 13.0% (6/46) with diameter 5-10 mm and 50.0% (23/46) vs 10.9% (5/46) with diameter more than 10 mm. Osteolytic lesion numbers found by CT were more than those by X ray [5(0-21) vs 0(0-4) lesions with diameter 5-10 mm (P < 0.001), 2(0-14) vs 0(0-2) lesions with diameter more than 10 mm (P < 0.001), respectively]. Patients with positive osteolytic lesions had higher percentage of RB1 gene deletion [46.7% (14/30) vs 18.8% (3/16), P < 0.001], D13s319 deletion [43.3% (13/30) vs 18.8% (3/16), P < 0.001] and high risk cytogenetic abnormalities [50.0% (15/30) vs 25.0% (4/16), P < 0.001]. CONCLUSIONS:Chest CT is more sensitive than plain X ray in detecting osteolytic myeloma bone disease. Osteolysis determined by CT is relevant to clinical DS stages and risk stratification of cytogenetic abnormalities.