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Photon-Counting CT Imaging- Myeloma

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Is Photon-Counting CT imaging better than conventional CT for multiple myeloma patients? Meaning, can we see early lytic lesions while using less radiation?

After all, bone involvement in multiple myeloma is the most defining challenge that MMers experience in their lifetimes.

The four types of scanning tests below are the most common types of imaging tests that newly diagnosed myeloma patients undergo-

  • X-ray
  • MRI
  • PET Scan
  • CT Scan

First things first. Blood and urine testing both have an important place in the diagnostic world of the MM patient.

However,  imaging the myeloma patient/survivor- x-ray, MRI, PET scan, CT scan, etc  is the only way to “see” into the person’s bone marrow for possible lytic lesions.

By the time a collection of monoclonal proteins causes bone pain or actually breaks a bone, it is clearly visible under and x-ray or other form of imaging test.

So the challenge of all MM patients is to see into their hone marrow while monoclonal proteins are just beginning to form lytic lesions.

Up until now (early 2023) there have not able to find any imaging methods that can see into the MM patient’s bone clearly enough without ALSO giving the patient lots of radiation.

Over the years, I have undergone dozens of imaging studies. The more radiation given to a person, the greater his/her risk of cancer. It is in my interest, as well as any MM patient’s interest, to undergo imaging that is the best of both worlds- clearly see into the bone marrow for early signs of lytic lesions while not getting too high a dose of radiation while doing so.

To Learn More About Bone Involvement in Multiple Myeloma read the posts below-

Have you been diagnosed with multiple myeloma? Are you experiencing bone pain? Scroll down the page, post a question or a comment and I will reply to you ASAP.

Thank you,

David Emerson

  • MM Survivor
  • MM Cancer Coach
  • Director PeopleBeatingCancer

September 6, 2022 —  New CT technology paired with artificial intelligence (AI)-based noise reduction offers superior detection of bone disease associated with multiple myeloma at lower radiation doses than conventional CT, according to a new study published in Radiology, a journal of the Radiological Society of North America (RSNA).

The new technology, known as photon-counting detector CT, debuted in the clinic in 2021 after decades of development. By directly converting individual x-ray photons into an electric signal, photon-counting detector CT can decrease the detector pixel size and improve the image’s spatial resolution.

“Additionally, photon-counting CT has demonstrated much better dose efficiency than standard CT, which allows for acquisition of ultra-high-resolution images of large areas of the body…”

The researchers also applied a deep learning AI technique developed at Mayo Clinic’s CT Clinical Innovation Center to reduce the noise in the very sharp photon-counting images. CT noise refers to an unwanted change in pixel values in the image, often loosely defined as the grainy appearance on cross-sectional imaging. The photon-counting detector CT with deep learning noise reduction demonstrated improvement in visualization and detected more lesions relative to conventional CT…

“We were excited to see that not only were we able to detect these features of multiple myeloma disease activity more clearly on the photon-counting scanner,” Dr. Baffour said, “with deep learning denoising techniques that allowed us to generate thinner image slices, we were able to detect more lesions than on the standard CT.” “

Prospective Multireader Evaluation of Photon-counting CT for Multiple Myeloma Screening

“Purpose- To determine whether photon-counting CT (PCCT) acquisition of whole-body CT images provides similar quantitative image quality and reader satisfaction for multiple myeloma screening at lower radiation doses than does standard energy-integrating detector (EID) CT…

Results ...PCCT helped identify more lesions… CNRs and SNRs were similar between modalities. PCCT had lower radiation doses than EID…dose-length product: EID, 1654.1 ± 409.6 vs PCCT, 253.4 ± 89.6…

Conclusion- This pilot investigation suggests that PCCT affords similar quantitative and qualitative scores as EID at significantly lower radiation doses…”

Radiology’s Ionising Radiation Paradox: Weighing the Indispensable Against the Detrimental in Medical Imaging

“Abstract– Ionising radiation stands as an indispensable protagonist in the narrative of medical imaging, underpinning diagnostic evaluations and therapeutic interventions across an array of medical conditions. However, this protagonist poses a paradox – its inestimable service to medicine coexists with an undercurrent of potential health risks, primarily DNA damage and subsequent oncogenesis…

Such techniques are vital in the early detection, accurate diagnosis, and successful treatment of various diseases, underpinning the crucial role of radiology in advancing patient care. Despite their remarkable diagnostic capabilities, these imaging techniques expose patients to ionising radiation, potentially increasing cancer incidence [6]

Computed Tomography (CT)

CT scans transcend standard imaging, producing intricate cross-sectional images using a rotating X-ray beam coupled with detector arrays [1]. Despite its diagnostic prowess, the increased complexity and sophistication of CT imaging also introduce higher radiation doses, delivering a radiation dose generally between 2 and 20 mSv [1,6]





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