Universität zu Köln

Borggrefe, Jan, Giravent, Sarah, Thomsen, Felix, Pena, Jaime, Campbell, Graeme, Wulff, Asmus, Guenther, Andreas, Heller, Martin and Glueer, Claus C. (2015). Association of QCT Bone Mineral Density and Bone Structure With Vertebral Fractures in Patients With Multiple Myeloma. J. Bone Miner. Res., 30 (7). S. 1329 - 1338. HOBOKEN: WILEY. ISSN 1523-4681

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Abstract

Computed tomography (CT) is used for staging osteolytic lesions and detecting fractures in patients with multiple myeloma (MM). In the OsteoLysis of Metastases and Plasmacell-infiltration Computed Tomography 2 study (OLyMP-CT) study we investigated whether patients with and without vertebral fractures show differences in bone mineral density (BMD) or microstructure that could be used to identify patients at risk for fracture. We evaluated whole-body CT scans in a group of 104 MM patients without visible osteolytic lesions using an underlying lightweight calibration phantom (Image Analysis Inc., Columbia, KY, USA). QCT software (StructuralInsight) was used for the assessment of BMD and bone structure of the T-11 or T-12 vertebral body. Age-adjusted standardized odds ratios (sORs) per SD change were derived from logistic regression analyses, and areas under the receiver operating characteristics (ROC) curve (AUCs) analyses were calculated. Forty-six of the 104 patients had prevalent vertebral fractures (24/60 men, 22/44 women). Patients with fractures were not significantly older than patients without fractures (mean +/- SD, 64 +/- 9.2 versus 62 +/- 12.3 years; p=0.4). Trabecular BMD in patients with fractures versus without fractures was 169 +/- 41 versus 192 +/- 51mg/cc (AUC=0.62 +/- 0.06, sOR=1.6 [1.1 to 2.5], p=0.02). Microstructural variables achieved optimal discriminatory power at bone thresholds of 150mg/cc. Best fracture discrimination for single microstructural variables was observed for trabecular separation (Tb.Sp) (AUC=0.72 +/- 0.05, sOR=2.4 (1.5 to 3.9), p<0.0001). In multivariate models AUCs improved to 0.77 +/- 0.05 for BMD and Tb.Sp, and 0.79 +/- 0.05 for Tb.Sp and trabecular thickness (Tb.Th). Compared to BMD values, these improvements of AUC values were statistically significant (p<0.0001). In MM patients, QCT-based analyses of bone structure derived from routine CT scans permit discrimination of patients with and without vertebral fractures. Rarefaction of the trabecular network due to plasma cell infiltration and osteoporosis can be measured. Deterioration of microstructural measures appear to be of value for vertebral fracture risk assessment and may indicate early stages of osteolytic processes not yet visible. (c) 2014 American Society for Bone and Mineral Research.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Borggrefe, Jan UNSPECIFIED UNSPECIFIED UNSPECIFIED Giravent, Sarah UNSPECIFIED UNSPECIFIED UNSPECIFIED Thomsen, Felix UNSPECIFIED UNSPECIFIED UNSPECIFIED Pena, Jaime UNSPECIFIED UNSPECIFIED UNSPECIFIED Campbell, Graeme UNSPECIFIED UNSPECIFIED UNSPECIFIED Wulff, Asmus UNSPECIFIED UNSPECIFIED UNSPECIFIED Guenther, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Heller, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Glueer, Claus C. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-399885
DOI:	10.1002/jbmr.2443
Journal or Publication Title:	J. Bone Miner. Res.
Volume:	30
Number:	7
Page Range:	S. 1329 - 1338
Date:	2015
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1523-4681
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language QUANTITATIVE COMPUTED-TOMOGRAPHY; FINITE-ELEMENT-ANALYSIS; CONVENTIONAL RADIOGRAPHY; WHOLE-BODY; CT; STRENGTH; THERAPY; RISK; MICROSTRUCTURE; THALIDOMIDE Multiple languages Endocrinology & Metabolism Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/39988