Efficacy of multidetector row computed tomography of the spine in patients with multiple myeloma: comparison with magnetic resonance imaging and fluorodeoxyglucose-positron emission tomography.

PURPOSE: The aim of our study was to compare the efficacy of multidetector row computed tomography (MDCT) with magnetic resonance imaging (MRI) and fluorodeoxyglucose-positron emission tomography (FDG-PET) for detection of spinal bone marrow involvement in patients with multiple myeloma.

MATERIALS AND METHODS: Ten patients with multiple myeloma stage III underwent MDCT and MRI of the spine and FDG-PET. The number and location of lesions detected by 3 modalities were recorded, and a lesion-by-lesion analysis was completed, using McNemar test. For MDCT, image analysis was performed according to the type of lesion (established by Laroche et al), and the efficacy of lesion detection was compared with that of the MRI and FDG-PET. P values less than 0.05 were considered statistically significant.

RESULTS: The MDCT, MRI, and FDG-PET detected the following numbers of lesions: 102 of 140 vertebrae, 95 of 140 vertebrae, and 84 of 140 vertebrae, respectively. The difference between the abilities of MDCT and MRI to detect lesions was not statistically significant (P = 0.289). However, the difference in effectiveness between MDCT and FDG-PET was statistically significant (P < 0.001). For small osteolytic lesions, less than 5 mm, the difference in effectiveness between MDCT and MRI was also statistically significant (P = 0.031).

CONCLUSIONS: The MDCT is very sensitive in detecting small osteolytic lesions in the spine, as compared with MRI and FDG-PET.