A prospective study of Skeletal survey versus Low-dose whole-body CT for Osteolytic lesions in Multiple Myeloma

Michael T. Gundesen*, Jon T. Asmussen, Einar Haukås, Michael Schubert, Niels Abildgaard, Fredrik Schjesvold, Thomas Lund

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

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Whole-body low-dose CT (WBLDCT) is recommended over classical skeletal surveys (CSS) for investigating bone disease in multiple myeloma (MM) based on retrospective studies. No prospective studies with serial follow-up scans exist. Objective: To compare WBLDCT to CSS for identifying progressive bone disease in MM in a prospective setting. Methods: Ninety-six patients with MM at Odense University Hospital and Stavanger Hospital were followed for up to four years. Patients were scanned with WBLDCT and CSS every year for the first two years and every six months thereafter or at suspicion of progression. Results: Nineteen cases of progressive bone disease were found using WBLDCT vs eight cases using CSS (p < 0.001). All cases of progressive bone disease using CSS were also identified by WBLDCT. Progression not found by CSS was primarily in the spine, sternum, and pelvis. Of the 19 cases, five patients had progressive bone disease only without other criteria for clinical progression. WBLDCT consistently identified more bone lesions per patient, 8.2 CI(6.8;9.6) vs CSS, 3.6 CI(2.7;4.5). Conclusion: WBLDCT outperformed CSS for finding progressive bone disease and osteolytic lesions. More new lesions were found during follow-up by WBLDCT than CSS. Using CSS for lytic lesions will underestimate progression rates. Our data offer prospective evidence for the current recommendation using WBLDCT for skeletal evaluations in patients with multiple myeloma.

Original languageEnglish
JournalEuropean journal of haematology
Issue number5
Pages (from-to)423-429
Publication statusPublished - May 2022


  • classical Skeletal Survey
  • multiple myeloma
  • osteolytic lesion
  • prospective
  • whole body low dose CT
  • Prospective Studies
  • Humans
  • Tomography, X-Ray Computed
  • Radiation Dosage
  • Multiple Myeloma/diagnosis
  • Osteolysis/diagnostic imaging
  • Whole Body Imaging
  • Retrospective Studies


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