INVESTIGATION OF THE RADIOLOGICAL TECHNIQUES TO DETECT OSTEOLYTIC LESIONS, FRACTURES, AND OSTEOPOROSIS IN MULTIPLE MYELOMA PATIENTS

Atakan Turgutkaya; İrfan Yavaş; Tuğba Şahin; Gokhan Sargın; Gürhan Kadıköylü; Ali Bolaman

doi:10.19161/etd.1147765

TR EN

MULTİPLE MYELOM HASTALARINDA OSTEOLİTİK LEZYON, FRAKTÜR VE OSTEOPOROZ TESPİTİNDE KULLANILAN RADYOLOJİK YÖNTEMLERİN İNCELENMESİ

Öz

Giriş: Multipl miyelom, klonal plazma hücrelerinin vücutta birikmesiyle oluşan hematolojik bir malignitedir. Osteolitik lezyon varlığı, semptomatik myelom için bir tanı kriteri olarak kabul edilmektedir. Ayrıca, kemik kaybı, patolojik kırıklar ve osteoporoz ile ilişkilidir. Litik lezyon varlığı ve kemik mineral kaybını saptamak için çeşitli görüntüleme yöntemleri ve çift enerjili x-ışını absorpsiyometrisi (DEXA) kullanılır. Bu çalışmada görüntüleme yöntemleri ve DEXA ile osteolitik lezyonların ve kemik mineral kaybının saptanma oranlarının araştırılması amaçlanmıştır. Gereç ve Yöntem: Bu çalışma 2004-2020 yılları arasında Adnan Menderes Üniversitesi Hastanesi/Türkiye'de gerçekleştirildi. Üç yüz on semptomatik myelom hastası retrospektif olarak incelendi. Osteolitik lezyon, fraktür ve plazmasitomların görüntüleme yöntemleriyle tespit oranı ve ayrıca DEXA ile kemik mineral kaybı oranı kaydedildi. Ayrıca bu bulguların cinsiyet, myelom tipi, litik lezyonlar ve osteoporoz ile ilişkileri araştırıldı. Bulgular: Litik lezyonlar, direkt grafi ve PET-BT ile hastaların sırasıyla %71,3'ünde ve %81,2'sinde saptadı. PET-BT'nin litik lezyonları saptamada duyarlılığı %96,1 ve özgüllüğü %90,6 idi. MR görüntülemesine, sadece fraktür şüphesi olan hastalarda başvuruldu ve MR çekilen tüm hastalarda fraktür tespit edildi. DEXA çekilen 113 hastada osteoporoz oranı %83,1 idi. Litik lezyon varlığı ile cinsiyet/myelom tipi arasında herhangi bir ilişki saptanmadı. Sonuç: Çalışmamız, osteolitik lezyonların cinsiyet veya myelom tipi ile korele olmadığını göstermiştir. PET-BT, osteolitik lezyonları saptamak için hassas ve spesifik bir yöntemdir. DEXA, osteoporozu saptamada duyarlı bir yöntem olmasına ragmen; özgüllüğü, litik lezyonları olan hastalarda sınırlı bir değere sahiptir.

Anahtar Kelimeler

INVESTIGATION OF THE RADIOLOGICAL TECHNIQUES TO DETECT OSTEOLYTIC LESIONS, FRACTURES, AND OSTEOPOROSIS IN MULTIPLE MYELOMA PATIENTS

Abstract

Aim: Multiple myeloma is a malignancy of clonal plasmacytes. Osteolytic lesions represent a criterion for symptomatic myeloma and are associated with bone loss, pathological fractures, and osteoporosis. Skeletal surveys with other sophisticated techniques and dual-energy x-ray absorptiometry (DEXA) are used to screen lytic lesions, and bone mineral loss, respectively. Here, we aimed to investigate the rates of detection regarding osteolytic lesions and bone mineral loss by several imaging techniques. Materials and Methods: The study was carried out in Adnan Menderes University Hospital/Turkey, between the years 2004- 2020. Three-hundred and ten symptomatic myeloma patients were screened retrospectively. The results of radiological techniques were recorded. The detection rate of osteolytic lesions, fractures, and plasmacytomas by imaging techniques, as well as bone mineral loss with DEXA was recorded. Also, associations with gender, myeloma type, lytic lesions, and osteoporosis were investigated. Results: Skeletal survey and PET-CT detected lytic lesions in 71.3% and 81.2% of patients, respectively. PET-CT had a sensitivity of 96.1% and specificity of 90.6% to detect lytic lesions. MRI was only used for patients with suspicious fractures and detected them for all patients who underwent MRI. The osteoporosis rate was 83.1% for 113 patients who underwent DEXA. Any association between lytic lesions and gender/myeloma type was not detected. Conclusion: Our study demonstrated that osteolytic lesions are not correlated with gender or myeloma type. PET-CT is a sensitive and specific method for detecting osteolytic lesions. Although DEXA is sensitive, its specificity is limited to detect osteoporosis in patients with lytic lesions.

Keywords

References

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Details

Primary Language

English

Subjects

Health Care Administration

Journal Section

Research Article

Authors

Atakan Turgutkaya ^*
0000-0001-8428-4730
Türkiye

İrfan Yavaş
0000-0003-1703-2175
Türkiye

Tuğba Şahin
0000-0002-4032-1189
Türkiye

Gokhan Sargın
0000-0002-3778-8351
Türkiye

Gürhan Kadıköylü
0000-0001-9979-7475
Türkiye

Ali Bolaman
0000-0003-0651-5462
Türkiye

Publication Date

December 18, 2023

Submission Date

July 25, 2022

Acceptance Date

March 17, 2023

Published in Issue

Year 2023 Volume: 62 Number: 4

DOI

https://doi.org/10.19161/etd.1147765

IZ

https://izlik.org/JA88BN58LR

Cite

RIS / Bibtex

Vancouver

1.Atakan Turgutkaya, İrfan Yavaş, Tuğba Şahin, Gokhan Sargın, Gürhan Kadıköylü, Ali Bolaman. INVESTIGATION OF THE RADIOLOGICAL TECHNIQUES TO DETECT OSTEOLYTIC LESIONS, FRACTURES, AND OSTEOPOROSIS IN MULTIPLE MYELOMA PATIENTS. EJM. 2023 Dec. 1;62(4):536-41. doi:10.19161/etd.1147765