{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T04:13:05Z","timestamp":1789186385080,"version":"build-2803163510"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"9","license":[{"start":{"date-parts":[[2020,9,25]],"date-time":"2020-09-25T00:00:00Z","timestamp":1600992000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,9,25]],"date-time":"2020-09-25T00:00:00Z","timestamp":1600992000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Blood Cancer J."],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>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.<\/jats:p>","DOI":"10.1038\/s41408-020-00360-9","type":"journal-article","created":{"date-parts":[[2020,9,25]],"date-time":"2020-09-25T15:04:17Z","timestamp":1601046257000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["The Role of Low Dose Whole Body CT in the Detection of Progression of Patients with Smoldering Multiple Myeloma"],"prefix":"10.1038","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6244-1229","authenticated-orcid":false,"given":"Maria","family":"Gavriatopoulou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andriani","family":"\u0392oultadaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vassilis","family":"Koutoulidis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6328-9783","authenticated-orcid":false,"given":"Ioannis","family":"Ntanasis-Stathopoulos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charis","family":"Bourgioti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panagiotis","family":"Malandrakis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Despina","family":"Fotiou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalini","family":"Migkou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolaos","family":"Kanellias","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evangelos","family":"Eleutherakis-Papaiakovou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8191-5832","authenticated-orcid":false,"given":"Efstathios","family":"Kastritis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5133-1422","authenticated-orcid":false,"given":"Evangelos","family":"Terpos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8990-3254","authenticated-orcid":false,"given":"Meletios A.","family":"Dimopoulos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lia-Angela","family":"Moulopoulos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,9,25]]},"reference":[{"key":"360_CR1","doi-asserted-by":"publisher","first-page":"1046","DOI":"10.1056\/NEJMra1011442","volume":"364","author":"A Palumbo","year":"2011","unstructured":"Palumbo, A. & Anderson, K. Multiple myeloma. N. Engl J. Med. 364, 1046\u20131060 (2011).","journal-title":"N. Engl J. Med."},{"key":"360_CR2","doi-asserted-by":"publisher","first-page":"5412","DOI":"10.1182\/blood-2008-12-194241","volume":"113","author":"O Landgren","year":"2009","unstructured":"Landgren, O. et al. Monoclonal gammopathy of undetermined significance (MGUS) consistently precedes multiple myeloma: a prospective study. Blood 113, 5412\u20135417 (2009).","journal-title":"Blood"},{"key":"360_CR3","doi-asserted-by":"publisher","first-page":"5649","DOI":"10.1056\/NEJMoa01133202","volume":"346","author":"RA Kyle","year":"2002","unstructured":"Kyle, R. A. et al. A long-term study of prognosis in monoclonal gammopathy of undetermined significance. N. Engl J. Med. 346, 5649 (2002).","journal-title":"N. Engl J. Med."},{"key":"360_CR4","doi-asserted-by":"publisher","first-page":"e538","DOI":"10.1016\/S1470-2045(14)70442-5","volume":"15","author":"SV Rajkumar","year":"2014","unstructured":"Rajkumar, S. V. et al. International myeloma working group updated criteria for the diagnosis of multiple myeloma. Lancet Oncol. 15, e538\u2013e548 (2014).","journal-title":"Lancet Oncol."},{"key":"360_CR5","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1016\/S0009-9260(67)80010-2","volume":"18","author":"GA Edelstyn","year":"1967","unstructured":"Edelstyn, G. A., Gillespie, P. J. & Grebbell, F. S. The radiological demonstration of osseous metastases. Experimental observations. Clin. Radiol. 18, 158\u2013162 (1967).","journal-title":"Clin. Radiol."},{"key":"360_CR6","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1111\/bjh.12346","volume":"162","author":"JC Regelink","year":"2013","unstructured":"Regelink, J. C. et al. Comparison of modern and conventional imaging techniques in establishing multiple myeloma-related bone disease: a systematic review. Br. J. Haematol. 162, 50\u201361 (2013).","journal-title":"Br. J. Haematol."},{"key":"360_CR7","doi-asserted-by":"publisher","first-page":"1199","DOI":"10.2214\/ajr.184.4.01841199","volume":"184","author":"MA Bredella","year":"2005","unstructured":"Bredella, M. A., Steinbach, L., Caputo, G., Segall, G. & Hawkins, R. Value of FDG PET in the assessment of patients with multiple myeloma. Am. J. Roentgenol. 184, 1199\u20131204 (2005).","journal-title":"Am. J. Roentgenol."},{"key":"360_CR8","doi-asserted-by":"publisher","first-page":"1121","DOI":"10.1200\/JCO.2006.08.5803","volume":"25","author":"R Walker","year":"2007","unstructured":"Walker, R. et al. Magnetic resonance imaging in multiple myeloma: diagnostic and clinical implications. J. Clin. Oncol. 25, 1121\u20131128 (2007).","journal-title":"J. Clin. Oncol."},{"key":"360_CR9","doi-asserted-by":"publisher","first-page":"1091","DOI":"10.2967\/jnumed.111.098830","volume":"53","author":"RC Walker","year":"2012","unstructured":"Walker, R. C., Brown, T. L., Jones-Jackson, L. B., De Blanche, L. & Bartel, T. Imaging of multiple myeloma and related plasma cell dyscrasias. J. Nucl. Med. 53, 1091\u20131101 (2012).","journal-title":"J. Nucl. Med."},{"key":"360_CR10","doi-asserted-by":"publisher","first-page":"1222","DOI":"10.1016\/j.ejrad.2014.02.008","volume":"83","author":"MB Wolf","year":"2014","unstructured":"Wolf, M. B. et al. Sensitivity of whole-body CT and MRI versus projection radiography in the detection of osteolyses in patients with monoclonal plasma cell disease. Eur. J. Radiol. 83, 1222\u20131230 (2014).","journal-title":"Eur. J. Radiol."},{"key":"360_CR11","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1007\/s00256-008-0607-4","volume":"38","author":"TG Gleeson","year":"2009","unstructured":"Gleeson, T. G. et al. Accuracy of whole-body low-dose multidetector CT (WBLDCT) versus skeletal survey in the detection of myelomatous lesions, and correlation of disease distribution with whole-body MRI (WBMRI). Skeletal Radiol. 38, 225\u2013236 (2009).","journal-title":"Skeletal Radiol."},{"key":"360_CR12","doi-asserted-by":"publisher","first-page":"342","DOI":"10.1097\/01.rct.0000237820.41549.c9","volume":"31","author":"J Hur","year":"2007","unstructured":"Hur, J., Yoon, C. S., Ryu, Y. H., Yun, M. J. & Suh, J. S. Efficacy of multidetector row computed tomography of the spine in patients with multiple myeloma: comparison with magnetic resonance imaging and fluorodeoxyglucose-positron emission tomography. J. Comput. Assist. Tomogr. 31, 342\u2013347 (2007).","journal-title":"J. Comput. Assist. Tomogr."},{"key":"360_CR13","doi-asserted-by":"publisher","first-page":"2490","DOI":"10.3892\/ol.2017.5723","volume":"13","author":"L Lambert","year":"2017","unstructured":"Lambert, L. et al. Whole-body low-dose computed tomography in multiple myeloma staging: superior diagnostic performance in the detection of bone lesions, vertebral compression fractures, rib fractures and extra skeletal findings compared to radiography with similar radiation exposure. Oncol. Lett. 13, 2490\u20132494 (2017).","journal-title":"Oncol. Lett."},{"key":"360_CR14","doi-asserted-by":"publisher","first-page":"749","DOI":"10.1046\/j.1365-2141.2003.04355.x","volume":"121","author":"International Myeloma Working Group.","year":"2003","unstructured":"International Myeloma Working Group. Criteria for the classification of monoclonal gammopathies, multiple myeloma and related disorders. Br. J. Haematol. 121, 749\u2013757 (2003).","journal-title":"Br. J. Haematol."},{"key":"360_CR15","doi-asserted-by":"publisher","DOI":"10.1038\/s41408-018-0124-1","volume":"8","author":"LA Moulopoulos","year":"2018","unstructured":"Moulopoulos, L. A. et al. Recommendations for acquisition, interpretation and reporting of whole body low dose CT in patients with multiple myeloma and other plasma cell disorders: a report of the IMWG Bone Working Group. Blood Cancer J. 8, 95 (2018).","journal-title":"Blood Cancer J."},{"key":"360_CR16","doi-asserted-by":"publisher","DOI":"10.1038\/s41408-018-0077-4","volume":"8","author":"A Lakshman","year":"2018","unstructured":"Lakshman, A. et al. Risk stratification of smoldering multiple myeloma incorporating revised IMWG diagnostic criteria. Blood Cancer J. 8, 59 (2018).","journal-title":"Blood Cancer J."},{"key":"360_CR17","doi-asserted-by":"publisher","first-page":"614","DOI":"10.1002\/ajh.21191","volume":"83","author":"SK Kumar","year":"2008","unstructured":"Kumar, S. K. et al. Autologous stem cell transplantation in patients of 70 years and older with multiple myeloma: results from a matched pair analysis. Am. J. Hematol. 83, 614\u2013617 (2008).","journal-title":"Am. J. Hematol."},{"key":"360_CR18","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1111\/j.1365-2141.2008.07069.x","volume":"141","author":"SK Kumar","year":"2008","unstructured":"Kumar, S. K. et al. Outcome after autologous stem cell transplantation for multiple myeloma in patients with preceding plasma cell disorders. Br. J. Haematol. 141, 205\u2013211 (2008).","journal-title":"Br. J. Haematol."},{"key":"360_CR19","doi-asserted-by":"publisher","first-page":"2516","DOI":"10.1182\/blood-2007-10-116129","volume":"111","author":"SK Kumar","year":"2008","unstructured":"Kumar, S. K. et al. Improved survival in multiple myeloma and the impact of novel therapies. Blood 111, 2516\u20132520 (2008).","journal-title":"Blood"},{"key":"360_CR20","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1016\/j.ejrad.2004.04.015","volume":"54","author":"M Horger","year":"2005","unstructured":"Horger, M. et al. Whole-body low-dose multidetector row-CT in the diagnosis of multiple myeloma: an alternative to conventional radiography. Eur. J. Radiol. 54, 289\u2013297 (2005).","journal-title":"Eur. J. Radiol."},{"key":"360_CR21","doi-asserted-by":"publisher","first-page":"1617","DOI":"10.1002\/cncr.22572","volume":"109","author":"M Horger","year":"2007","unstructured":"Horger, M. et al. The benefit of using whole-body, low dose, nonenhanced, multidetector computed tomography for follow-up and therapy response monitoring in patients with multiple myeloma. Cancer 109, 1617\u20131626 (2007).","journal-title":"Cancer"},{"key":"360_CR22","doi-asserted-by":"publisher","first-page":"206","DOI":"10.3109\/07357907.2013.764565","volume":"31","author":"K Princewill","year":"2013","unstructured":"Princewill, K., Kyere, S., Awan, O. & Mulligan, M. Multiple myeloma lesion detection with whole body CT versus radiographic skeletal survey. Cancer Investig. 31, 206\u2013211 (2013).","journal-title":"Cancer Investig."},{"key":"360_CR23","doi-asserted-by":"publisher","first-page":"1097","DOI":"10.2214\/AJR.07.2635","volume":"190","author":"A Baur-Melnyk","year":"2008","unstructured":"Baur-Melnyk, A. et al. Whole-body MRI versus whole-body MDCT for staging of multiple myeloma. Am. J. Roentgenol. 190, 1097\u20131104 (2008).","journal-title":"Am. J. Roentgenol."},{"key":"360_CR24","doi-asserted-by":"publisher","DOI":"10.1038\/bcj.2017.78","volume":"7","author":"J Hillengass","year":"2017","unstructured":"Hillengass, J. et al. Whole-body computed tomography versus conventional skeletal survey in patients with multiple myeloma: a study of the international myeloma working group. Blood Cancer J. 7, e599 (2017).","journal-title":"Blood Cancer J."},{"key":"360_CR25","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1007\/s00330-007-0738-3","volume":"18","author":"P Kropil","year":"2008","unstructured":"Kropil, P. et al. Comparison of whole-body 64-slice multidetector computed tomography and conventional radiography in staging of multiple myeloma. Eur. Radiol. 18, 51\u201358 (2008).","journal-title":"Eur. Radiol."},{"key":"360_CR26","first-page":"147","volume":"3","author":"B Wirk","year":"2012","unstructured":"Wirk, B., Bush, C. H., Hou, W., Pettiford, L. & Moreb, J. S. Detection of skeletal lesions by whole bodymultidetector computed tomography in multiple myeloma has no impact on long-term outcomes post autologous hematopoietic cell transplantation. World J. Oncol. 3, 147\u2013157 (2012).","journal-title":"World J. Oncol."},{"key":"360_CR27","doi-asserted-by":"publisher","first-page":"2322","DOI":"10.1016\/j.ejrad.2013.08.036","volume":"82","author":"D Ippolito","year":"2013","unstructured":"Ippolito, D. et al. Diagnostic value of whole-body low-dose computed tomography (WBLDCT) in bone lesions detection in patients with multiple myeloma (MM). Eur. J. Radiol. 82, 2322\u20132327 (2013).","journal-title":"Eur. J. Radiol."},{"key":"360_CR28","doi-asserted-by":"publisher","first-page":"773","DOI":"10.1007\/s00256-018-3066-6","volume":"48","author":"FJ Simeone","year":"2019","unstructured":"Simeone, F. J. et al. Skeletal radiology, Value of low-dose whole-body CT in the management of patients with multiple myeloma and precursor states. Skeletal Radiol. 48, 773\u2013779, https:\/\/doi.org\/10.1007\/s00256-018-3066-6 (2019).","journal-title":"Skeletal Radiol."},{"key":"360_CR29","doi-asserted-by":"publisher","first-page":"4172","DOI":"10.1182\/blood-2013-08-520890","volume":"122","author":"A Dispenzieri","year":"2013","unstructured":"Dispenzieri, A. et al. Smoldering multiple myeloma requiring treatment: time for a new definition. Blood 122, 4172\u20134181 (2013).","journal-title":"Blood"},{"key":"360_CR30","doi-asserted-by":"publisher","first-page":"478","DOI":"10.1182\/asheducation-2013.1.478","volume":"2013","author":"O Landgren","year":"2013","unstructured":"Landgren, O. Monoclonal gammopathy of undetermined significance and smoldering multiple myeloma: biological insights and early treatment strategies. Hematology Am. Soc. Hematol. Educ. Program. 2013, 478\u2013487 (2013).","journal-title":"Hematology Am. Soc. Hematol. Educ. Program."},{"key":"360_CR31","doi-asserted-by":"publisher","first-page":"1199","DOI":"10.1007\/s11547-019-01068-y","volume":"124","author":"M Millor","year":"2019","unstructured":"Millor, M. et al. Whole-body computed tomography: a new point of view in a hospital check-up unit? Our experience in 6516 patients. Radiol. Med. 124, 1199\u20131211 (2019).","journal-title":"Radiol. Med."},{"key":"360_CR32","doi-asserted-by":"publisher","first-page":"e302","DOI":"10.1016\/S1470-2045(19)30309-2","volume":"20","author":"J Hillengass","year":"2019","unstructured":"Hillengass, J. et al. International myeloma working group consensus recommendations on imaging in monoclonal plasma cell disorders. Lancet Oncol. 20, e302\u2013e312 (2019).","journal-title":"Lancet Oncol."}],"container-title":["Blood Cancer Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41408-020-00360-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41408-020-00360-9","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41408-020-00360-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,5]],"date-time":"2022-12-05T14:34:18Z","timestamp":1670250858000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41408-020-00360-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,25]]},"references-count":32,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2020,9]]}},"alternative-id":["360"],"URL":"https:\/\/doi.org\/10.1038\/s41408-020-00360-9","relation":{},"ISSN":["2044-5385"],"issn-type":[{"value":"2044-5385","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9,25]]},"assertion":[{"value":"28 July 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 August 2020","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 September 2020","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 September 2020","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare that they have no conflict of interest.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}],"article-number":"93"}}