Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Radio-diagnosis

Objective: The goal of this study was to establish the feasibility of a low-dose whole-body multidetector row-CT (WB-LD CT) protocol in the diagnosis, staging and follow up of multiple myeloma, able to replace whole-body conventional radiography, which is currently still state-of-the-art in these patients, and also appropriately deliver supplementary data about unexpected findings outside the skeleton, for instance in the lung, abdominal or pelvic viscera. with emphasis on the comparison of image resolution on axial and multiplanar reformatted (MPR) scans and reduction of radiation dose. Results: In 14/24 patients, WB-LD CT enabled correct classification of multiple myeloma patients with good delineation of small lytic lesions as well as detection of other skeletal and extra skeletal findings. Absorbed radiation dose of WB-LD CT calculated at a tube current time product range of 40 to 70mAs with automatic tube current modulation was 3.4-fold higher than the absorbed radiation dose of plain radiographic skeletal survey (6.741 cGy versus 1.953 cGy). Discussion: Our study showed that whole-body low-dose MDCT investigational protocols are appropriate for the diagnosis of lytic bone changes and for assessment of fracture risk in multiple myeloma patients, representing a serious alternative to current standards.

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