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    Imaging, QoL and Patient-Reported Outcome and Supportive Care

    WHOLE BODY LOW DOSE CT (WBLDCT), AS INITIAL IMAGING MODALITY FOR NEWLY DIAGNOSED MULTIPLE MYELOMA PATIENTS: EXPERIENCE FROM A TERTIARY CARE CENTER IN NORTH INDIA

    P-149: WHOLE BODY LOW DOSE CT (WBLDCT), AS INITIAL IMAGING MODALITY FOR NEWLY DIAGNOSED MULTIPLE MYELOMA PATIENTS: EXPERIENCE FROM A TERTIARY CARE CENTER IN NORTH INDIA

    Thursday, September 26, 2024

    • Sanjeev sanjeev, DM

      Additional professor
      Sanjay Gandhi Postgraduate Institute of Medical Sciences
      Lucknow, Uttar Pradesh, India

    Introduction: For decades, the main imaging modality to detect bony lesions in multiple myeloma was whole body skeletal survey.1 Subsequently, CT, MRI and PET CT came to forefront with better sensitivity and specificity as well as detection of extramedullary soft tissue disease. The disadvantage with CT was the high radiation dose required; hence, low dose CT protocols were developed and has become one of the investigations of choice along with PET CT and MRI to detect bony lesions in multiple myeloma.2 We herein present Whole body low dose CT (WBLDCT) findings in patients of plasma cell dyscrasia presenting at our institute.

    Methods: We retrospectively collected the data from Hospital information system (HIS) & Radiology department for patients of plasma cell dyscrasia from Jan 2022 to Sept 2023.

    Results: The patients included were 73, out of which there were 58 cases of multiple myeloma, 10 cases of MGUS, 2 cases of smoldering myeloma, 1 case of non secretory myeloma, 1 case of plasmacytoma and 1 case of plasma cell leukemia. Lytic lesions were detected in 31 out of the 58 patients of multiple myeloma. The most commonly affected site was vertebra (31.5%) followed by sacrum and pelvis (26%), ribs and sternum (20.5%), skull (20.5%) and long bones (20.5%). Extramedullary disease was present in 7 patients (9.6%). In 8 patients, bone lesions were the only CRAB feature present, which upgraded the diagnosis from SMM to multiple myeloma. We further analyzed the 13 patients (17.8%) who had 3 or more lytic lesions. Only 2 of these patients had hypercalcemia. On serum immunofixation, 7 of these patients were IgG kappa, 2 were kappa LC, 2 were lambda LC, 1 was IgA lambda and 1 was IgA kappa. 8 of these patients had normal cytogenetics while 5 had gain1q. 11 patients belonged to ISS Stage 3 while 2 patients belonged to II Stage 2. 9 patients had R ISS Stage 2 while 4 patients had R ISS Stage 3.

    Conclusions: This is one the first studies describing the spectrum of bony lesions in Whole body low dose CT in myeloma patients in Indian Scenario.