Non-osseous incidental findings in low-dose whole-body CT in patients with multiple myeloma.

Abstract

The purpose of this study was to identify the frequency and grading of non-osseous incidental findings (NOIF) in non-contrast whole-body low-dose CT (LDCT) in patients with multiple myeloma. In the time period from 2010 to 2013, 93 patients with multiple myeloma were staged by non-contrast whole-body LDCT at our radiological department. LDCT images were analysed retrospectively for NOIF, which also included unsuspected extramedullary manifestation of multiple myeloma. All NOIF were classified as major or clinically significant, moderate or possibly clinically significant and minor or not clinically significant. Medical records were analysed regarding further investigation and follow-up of the identified NOIF. In the 93 patients, 295 NOIF were identified (on average, 3.2 NOIF per patient). Most of the NOIF (52.4%) were not clinically significant, 25.8% of the NOIF were possibly clinically significant and 21.8% of the NOIF were clinically significant. Clinically significant NOIF were investigated further by CT after intravenous administration of contrast medium and/or by ultrasound or MRI. In 34 of these cases, extramedullary relapse of myeloma, occult carcinoma or infectious/septic incidental findings were diagnosed (11.5% of all NOIF). In the remaining 10.3% of the NOIF classified as clinically significant, various benign lesions were diagnosed. LDCT detected various non-osseous lesions in patients with multiple myeloma. 36.6% of the patients had clinically significant NOIF. Therefore, LDCT examinations in patients with multiple myeloma should be evaluated carefully for the presence of NOIF. LDCT identified several NOIF. A total of 36.6% of patients with multiple myeloma had clinically significant NOIF. Radiologists should analyse LDCT examinations in patients with multiple myeloma not only for bone lesions, but also for lesions in other organs.