To compare whole-body low-dose 64-slice multidetector computed tomography (WBLDCT) with conventional radiography in the detection of bone lesions in patients with Multiple Myeloma.

A total of 20 patients with known Multiple Myeloma (15), Smoldering Myeloma (2) and Solitary Plasmatocytoma (2) underwent WBLDCT and conventional skeletal survey in a seven-month period. Scanning parameters were based on reference data (tube voltage 120-140 Kv, tube current 40mAs) which allow significant reduction of effective radiation dose, estimated less than two fold higher than the mean radiation dose of conventional x-ray skeletal survey. Two experienced radiologists evaluated blindly WBLDCT scans for bone lesions in axial and multiplanar reformatted images. Extra-osseous findings were also...

WBLDCT showed 38 bone lesions in 8 patients, while 21 bone lesions in 5 patientswere seen inskeletal survey. WBLDCT showed a total of 17 lesions more than x-rays, all of them were <1cm in diameter and located in posterior vertebral elements, clavicles (Fig.1,2), scapulae and lower extremities. WBLDCT allowed early diagnosis in two asymptomatic and one symptomatic patients with negative skeletal survey. WBLDCT allowed assessment of spinal cord and foraminal stenosis due to compression in 3 patients. The degree of stenoses could not be estimated...

WBLDCT reveals more lesions compared with skeletal survey, with significantly lower radiation exposure compared to conventional MDCT. WBLDCT seems to be more sensitive in detecting small (<1cm) osteolytic lesions, especially in parts of skeleton that are difficult to visualize on conventional radiographs, such as clavicles, epine, pelvis whereas relate extra-skeletal pathologiew, such as nephrolithiasis, can be shown. Improved sensitivity in te detection os bone onvolvement may leas to more accurate planning in patoents ith multiple myeloma.