Association of QCT Bone Mineral Density and Bone Structure With Vertebral Fractures in Patients With Multiple Myeloma

Autores
Borggrefe, Jan; Giravent, Sarah; Thomsen, Felix Sebastian Leo; Peña, Jaime; Campbell, Graeme; Wulff, A.; Günther, A.; Heller, Martin; Glüer, Claus C.
Año de publicación
2015
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
Purpose: 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 (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. Methods and Materials: 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 T11 or T12 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. Results: 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 ± 51 mg/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 150 mg/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). Conclusion: 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.
Fil: Borggrefe, Jan . Universitätsklinikum Schleswig Holstein. Klinik für Radiologie und Neuroradiologie. Sektion für Biomedizinische Bildgebung; Alemania. Uniklinik Köln. Institut und Poliklinik für Diagnostische Radiologie; Alemania
Fil: Giravent, Sarah . Universitätsklinikum Schleswig Holstein. Klinik für Radiologie und Neuroradiologie. Sektion für Biomedizinische Bildgebung; Alemania
Fil: Thomsen, Felix Sebastian Leo. Universitätsklinikum Schleswig Holstein. Klinik für Radiologie und Neuroradiologie. Sektion für Biomedizinische Bildgebung; Alemania. Universidad Nacional del Sur; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Bahia Blanca; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Bahía Blanca. Instituto de Investigación en Ingeniería Eléctrica; Argentina
Fil: Peña, Jaime . Universitätsklinikum Schleswig Holstein. Klinik für Radiologie und Neuroradiologie. Sektion für Biomedizinische Bildgebung; Alemania
Fil: Campbell, Graeme . Universitätsklinikum Schleswig Holstein. Klinik für Radiologie und Neuroradiologie. Sektion für Biomedizinische Bildgebung; Alemania
Fil: Wulff, A.. Universitätsklinikum Schleswig Holstein. Klinik für Radiologie und Neuroradiologie. Sektion für Biomedizinische Bildgebung; Alemania
Fil: Günther, A.. Universitätsklinikum Schleswig Holstein. Klinik für Innere Medizin. Sektion für Immun- und Stammzelltransplantation; Alemania
Fil: Heller, Martin . Universitätsklinikum Schleswig Holstein. Klinik für Radiologie und Neuroradiologie. Sektion für Biomedizinische Bildgebung; Alemania
Fil: Glüer, Claus C.. Universitätsklinikum Schleswig Holstein. Klinik für Radiologie und Neuroradiologie. Sektion für Biomedizinische Bildgebung; Alemania
Materia
Multiple Myeloma
Osteoporosis
Vertebral Fracture
Qct
Fracture Risk
Trabecular Separation
Bmd
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/11745
Acceder
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oai_identifier_str oai:ri.conicet.gov.ar:11336/11745
network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling Association of QCT Bone Mineral Density and Bone Structure With Vertebral Fractures in Patients With Multiple MyelomaBorggrefe, Jan Giravent, Sarah Thomsen, Felix Sebastian LeoPeña, Jaime Campbell, Graeme Wulff, A.Günther, A.Heller, Martin Glüer, Claus C.Multiple MyelomaOsteoporosisVertebral FractureQctFracture RiskTrabecular SeparationBmdhttps://purl.org/becyt/ford/3.2https://purl.org/becyt/ford/3Purpose: 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 (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. Methods and Materials: 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 T11 or T12 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. Results: 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 ± 51 mg/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 150 mg/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). Conclusion: 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.Fil: Borggrefe, Jan . Universitätsklinikum Schleswig Holstein. Klinik für Radiologie und Neuroradiologie. Sektion für Biomedizinische Bildgebung; Alemania. Uniklinik Köln. Institut und Poliklinik für Diagnostische Radiologie; AlemaniaFil: Giravent, Sarah . Universitätsklinikum Schleswig Holstein. Klinik für Radiologie und Neuroradiologie. Sektion für Biomedizinische Bildgebung; AlemaniaFil: Thomsen, Felix Sebastian Leo. Universitätsklinikum Schleswig Holstein. Klinik für Radiologie und Neuroradiologie. Sektion für Biomedizinische Bildgebung; Alemania. Universidad Nacional del Sur; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Bahia Blanca; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Bahía Blanca. Instituto de Investigación en Ingeniería Eléctrica; ArgentinaFil: Peña, Jaime . Universitätsklinikum Schleswig Holstein. Klinik für Radiologie und Neuroradiologie. Sektion für Biomedizinische Bildgebung; AlemaniaFil: Campbell, Graeme . Universitätsklinikum Schleswig Holstein. Klinik für Radiologie und Neuroradiologie. Sektion für Biomedizinische Bildgebung; AlemaniaFil: Wulff, A.. Universitätsklinikum Schleswig Holstein. Klinik für Radiologie und Neuroradiologie. Sektion für Biomedizinische Bildgebung; AlemaniaFil: Günther, A.. Universitätsklinikum Schleswig Holstein. Klinik für Innere Medizin. Sektion für Immun- und Stammzelltransplantation; AlemaniaFil: Heller, Martin . Universitätsklinikum Schleswig Holstein. Klinik für Radiologie und Neuroradiologie. Sektion für Biomedizinische Bildgebung; AlemaniaFil: Glüer, Claus C.. Universitätsklinikum Schleswig Holstein. Klinik für Radiologie und Neuroradiologie. Sektion für Biomedizinische Bildgebung; AlemaniaWiley2015-07info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/vnd.openxmlformats-officedocument.wordprocessingml.documentapplication/pdfhttp://hdl.handle.net/11336/11745Borggrefe, Jan ; Giravent, Sarah ; Thomsen, Felix Sebastian Leo; Peña, Jaime ; Campbell, Graeme ; et al.; Association of QCT Bone Mineral Density and Bone Structure With Vertebral Fractures in Patients With Multiple Myeloma; Wiley; Journal Of Bone And Mineral Research; 30; 7; 7-2015; 1329-13371523-4681enginfo:eu-repo/semantics/altIdentifier/url/http://onlinelibrary.wiley.com/doi/10.1002/jbmr.2443/abstractinfo:eu-repo/semantics/altIdentifier/url/http://dx.doi.org/10.1002/jbmr.2443info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-sa/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-03T10:06:35Zoai:ri.conicet.gov.ar:11336/11745instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-09-03 10:06:35.431CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Association of QCT Bone Mineral Density and Bone Structure With Vertebral Fractures in Patients With Multiple Myeloma
title Association of QCT Bone Mineral Density and Bone Structure With Vertebral Fractures in Patients With Multiple Myeloma
spellingShingle Association of QCT Bone Mineral Density and Bone Structure With Vertebral Fractures in Patients With Multiple Myeloma
Borggrefe, Jan
Multiple Myeloma
Osteoporosis
Vertebral Fracture
Qct
Fracture Risk
Trabecular Separation
Bmd
title_short Association of QCT Bone Mineral Density and Bone Structure With Vertebral Fractures in Patients With Multiple Myeloma
title_full Association of QCT Bone Mineral Density and Bone Structure With Vertebral Fractures in Patients With Multiple Myeloma
title_fullStr Association of QCT Bone Mineral Density and Bone Structure With Vertebral Fractures in Patients With Multiple Myeloma
title_full_unstemmed Association of QCT Bone Mineral Density and Bone Structure With Vertebral Fractures in Patients With Multiple Myeloma
title_sort Association of QCT Bone Mineral Density and Bone Structure With Vertebral Fractures in Patients With Multiple Myeloma
dc.creator.none.fl_str_mv Borggrefe, Jan
Giravent, Sarah
Thomsen, Felix Sebastian Leo
Peña, Jaime
Campbell, Graeme
Wulff, A.
Günther, A.
Heller, Martin
Glüer, Claus C.
author Borggrefe, Jan
author_facet Borggrefe, Jan
Giravent, Sarah
Thomsen, Felix Sebastian Leo
Peña, Jaime
Campbell, Graeme
Wulff, A.
Günther, A.
Heller, Martin
Glüer, Claus C.
author_role author
author2 Giravent, Sarah
Thomsen, Felix Sebastian Leo
Peña, Jaime
Campbell, Graeme
Wulff, A.
Günther, A.
Heller, Martin
Glüer, Claus C.
author2_role author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Multiple Myeloma
Osteoporosis
Vertebral Fracture
Qct
Fracture Risk
Trabecular Separation
Bmd
topic Multiple Myeloma
Osteoporosis
Vertebral Fracture
Qct
Fracture Risk
Trabecular Separation
Bmd
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.2
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv Purpose: 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 (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. Methods and Materials: 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 T11 or T12 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. Results: 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 ± 51 mg/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 150 mg/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). Conclusion: 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.
Fil: Borggrefe, Jan . Universitätsklinikum Schleswig Holstein. Klinik für Radiologie und Neuroradiologie. Sektion für Biomedizinische Bildgebung; Alemania. Uniklinik Köln. Institut und Poliklinik für Diagnostische Radiologie; Alemania
Fil: Giravent, Sarah . Universitätsklinikum Schleswig Holstein. Klinik für Radiologie und Neuroradiologie. Sektion für Biomedizinische Bildgebung; Alemania
Fil: Thomsen, Felix Sebastian Leo. Universitätsklinikum Schleswig Holstein. Klinik für Radiologie und Neuroradiologie. Sektion für Biomedizinische Bildgebung; Alemania. Universidad Nacional del Sur; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Bahia Blanca; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Bahía Blanca. Instituto de Investigación en Ingeniería Eléctrica; Argentina
Fil: Peña, Jaime . Universitätsklinikum Schleswig Holstein. Klinik für Radiologie und Neuroradiologie. Sektion für Biomedizinische Bildgebung; Alemania
Fil: Campbell, Graeme . Universitätsklinikum Schleswig Holstein. Klinik für Radiologie und Neuroradiologie. Sektion für Biomedizinische Bildgebung; Alemania
Fil: Wulff, A.. Universitätsklinikum Schleswig Holstein. Klinik für Radiologie und Neuroradiologie. Sektion für Biomedizinische Bildgebung; Alemania
Fil: Günther, A.. Universitätsklinikum Schleswig Holstein. Klinik für Innere Medizin. Sektion für Immun- und Stammzelltransplantation; Alemania
Fil: Heller, Martin . Universitätsklinikum Schleswig Holstein. Klinik für Radiologie und Neuroradiologie. Sektion für Biomedizinische Bildgebung; Alemania
Fil: Glüer, Claus C.. Universitätsklinikum Schleswig Holstein. Klinik für Radiologie und Neuroradiologie. Sektion für Biomedizinische Bildgebung; Alemania
description Purpose: 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 (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. Methods and Materials: 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 T11 or T12 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. Results: 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 ± 51 mg/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 150 mg/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). Conclusion: 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.
publishDate 2015
dc.date.none.fl_str_mv 2015-07
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/11745
Borggrefe, Jan ; Giravent, Sarah ; Thomsen, Felix Sebastian Leo; Peña, Jaime ; Campbell, Graeme ; et al.; Association of QCT Bone Mineral Density and Bone Structure With Vertebral Fractures in Patients With Multiple Myeloma; Wiley; Journal Of Bone And Mineral Research; 30; 7; 7-2015; 1329-1337
1523-4681
url http://hdl.handle.net/11336/11745
identifier_str_mv Borggrefe, Jan ; Giravent, Sarah ; Thomsen, Felix Sebastian Leo; Peña, Jaime ; Campbell, Graeme ; et al.; Association of QCT Bone Mineral Density and Bone Structure With Vertebral Fractures in Patients With Multiple Myeloma; Wiley; Journal Of Bone And Mineral Research; 30; 7; 7-2015; 1329-1337
1523-4681
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/url/http://onlinelibrary.wiley.com/doi/10.1002/jbmr.2443/abstract
info:eu-repo/semantics/altIdentifier/url/http://dx.doi.org/10.1002/jbmr.2443
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
eu_rights_str_mv openAccess
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application/vnd.openxmlformats-officedocument.wordprocessingml.document
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dc.publisher.none.fl_str_mv Wiley
publisher.none.fl_str_mv Wiley
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reponame_str CONICET Digital (CONICET)
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instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
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