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

Abstract Multiple myeloma (MM) is the second most common hematological malignancy, characterized by plasma cell bone marrow infiltration and end-organ involvement. Smoldering MM (SMM) is an intermediate clinical entity between MGUS and MM, with a risk of progression to symptomatic disease 10% per year. Bone disease is the most frequent symptom of MM, with ~90% of patients developing bone lesions throughout their disease course. Therefore, imaging plays a crucial role in diagnosis and management. Whole-body low-dose CT (WBLDCT) is widely available and has been incorporated in the latest diagnostic criteria of the IMWG. The purpose of this study was to evaluate the role of WBLDCT in the early identification of lesions in patients with SMM who progress solely with bone disease. In total, 100 asymptomatic patients were consecutively assessed with WBLDCT from July 2013 until March 2020 at baseline, 1-year after diagnosis and every 1 year thereafter. Ten percent of patients were identified as progressors with this single imaging modality. This is the first study to evaluate prospectively patients with SMM at different time points to identify early bone lesions related to MM evolution. Serial WBLDCT studies can identify early myeloma evolution and optimize disease monitoring and therapeutic strategies.

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Lesson by SARS-Cov 2 disease (COVID-19): whole body CT angiography detection of relevant and other/incidental systemic vascular findings

10.21203/rs.3.rs-65060/v1 ◽

2020 ◽

Author(s):

Gaetano Rea ◽

Francesco Lassandro ◽

Roberta Lieto ◽

Giorgio Bocchini ◽

Federica Romano ◽

...

Keyword(s):

Incidental Findings ◽

Whole Body ◽

Vascular Involvement ◽

Vascular Events ◽

Icu Patients ◽

Whole Body Ct ◽

Study Population ◽

Disease Behavior ◽

The Brain ◽

Body Ct

Abstract Objectives: The aim of our study was to assess the frequency distribution of relevant and incidental vascular events in a retrospective cohort of 42 COVID-19 patients. Methods: All patients were studied by whole-body CT angiography.Twenty-three out of 42 patients were admitted to the intensive care unit (ICU). Results: Relevant vascular events were recorded in the 71.4% of the whole study population. Pulmonary embolism was the most frequent one both in ICU and no-ICU cases (56.5% vs10.5%, p=0.002). Ischemic infarction of other organs was affecting with an increasing prevalence the gut, the spleen, the liver, the brain and the kidney, with a simultaneous ischemic occurrence in some cases. Multi-focal venous thrombosis was also represented especially in ICU patients (p=0.005). Among incidental findings, splanchnic vessels little-size aneurysms were reported in the 40% of the whole population, with relative frequencies similarly distributed in ICU and no-ICU patients.Conclusions: Vascular involvement is not negligible in COVID-19 and should be carefully investigated as may significantly affect disease behavior and prognosis.

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