{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T23:38:59Z","timestamp":1784590739403,"version":"3.55.0"},"reference-count":33,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rofo"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title>\n                  <jats:p>Das Multiple Myelom (MM) ist die zweith\u00e4ufigste h\u00e4matoonkologische Erkrankung und charakterisiert durch eine klonale Proliferation maligner Plasmazellen sowie eine Knochenmarksinfiltration. Der f\u00fcr die Diagnostik und Therapieinitiierung wichtige Knochenmarksinfiltrationsgrad wird mittels Punktion festgelegt. W\u00e4hrend die MRT und CT als Standardmethoden zur bildgebenden Diagnostik fokaler L\u00e4sionen und Osteolysen gelten, st\u00f6\u00dft insbesondere die CT bei diffusen Infiltrationsmustern ohne Osteolysen an ihre Grenzen. Spektrale CT-Techniken bieten durch Materialdekomposition eine vielversprechende Alternative zur Erfassung einer Knochenmarksinfiltration.<\/jats:p>\n                  <jats:p>Es erfolgte eine systematische Literaturrecherche in der PubMed-Datenbank zu relevanten Stichworten in zwischen 01\/2010 und 12\/2024 publizierten Artikeln. Eingeschlossen wurden Originalstudien, die spektrale CT-Techniken hinsichtlich der Beurteilung einer Knochenmarksinfiltration evaluierten. Ausgeschlossen wurden Artikel mit anderem Fokus, z.B. Frakturdetektion. Es erfolgte eine qualitative Synthese der Studienergebnisse.<\/jats:p>\n                  <jats:p>Spektrale CT-Techniken k\u00f6nnen die Differenzierung zwischen gesundem und infiltriertem Knochenmark verbessern. Insbesondere die h\u00e4ufig angewendete virtuelle Calciumsuppression zeigt eine gute Sensitivit\u00e4t und Spezifit\u00e4t verglichen mit der Histologie, Serologie oder MRT. Auch f\u00fcr die Differenzierung verschiedener Knochenmarksinfiltrationsmuster, der Krankheitsaktivit\u00e4t und des Therapieansprechens bietet die Spektral-CT Potenzial. Einschr\u00e4nkungen liegen in der Sensitivit\u00e4t der Differenzierung einer moderaten Infiltration gegen\u00fcber rotem Knochenmark sowie geringen Kohortengr\u00f6\u00dfen. Multizentrische Analysen verschiedener Ger\u00e4tehersteller sind erforderlich, um den Stellenwert der spektralen CT im Vergleich zur MRT, den pr\u00e4diktiven Nutzen von Spektral-CT-Biomarkern sowie die Rolle weniger untersuchter Materialdichtekarten und Texturmerkmale, als auch der Photon-Counting-CT zu validieren.<\/jats:p>","DOI":"10.1055\/a-2625-5643","type":"journal-article","created":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T23:30:20Z","timestamp":1753313420000},"page":"36-54","source":"Crossref","is-referenced-by-count":1,"title":["Stellenwert spektraler CT-Techniken zur Beurteilung der Knochenmarksinfiltration beim Multiplen Myelom: ein systematisches Literaturreview"],"prefix":"10.1055","volume":"198","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-4199-1807","authenticated-orcid":false,"given":"Yasmin Fede","family":"Melzer","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Erley","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3032-2321","authenticated-orcid":false,"given":"Inka","family":"Ristow","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niklas","family":"Schubert","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graeme Michael","family":"Campbell","sequence":"additional","affiliation":[{"name":"Clinical Science, Philips GmbH Market DACH, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bj\u00f6rn","family":"Busse","sequence":"additional","affiliation":[{"name":"Institute of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katja","family":"Weisel","sequence":"additional","affiliation":[{"name":"Center for Oncology, II. Medical Clinic and Polyclinic, University Medical Center Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerhard","family":"Adam","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4542-0140","authenticated-orcid":false,"given":"Isabel","family":"Molwitz","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,7,23]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1038\/s41572-024-00529-7","article-title":"Multiple myeloma","volume":"10","author":"F Malard","year":"2024","journal-title":"Nat Rev Dis Primers"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"e538","DOI":"10.1016\/S1470-2045(14)70442-5","article-title":"International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma","volume":"15","author":"SV Rajkumar","year":"2014","journal-title":"The Lancet Oncology"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1007\/s00117-021-00943-y","article-title":"Radiologische Diagnostik des multiplen Myeloms: Rolle der Bildgebungsverfahren und aktuelle S3-Leitlinie","volume":"62","author":"M-A Weber","year":"2022","journal-title":"Radiologe"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"644","DOI":"10.1182\/blood-2018-08-825356","article-title":"Imaging in multiple myeloma: How? When?","volume":"133","author":"E Zamagni","year":"2019","journal-title":"Blood"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1521","DOI":"10.1007\/s00256-021-03979-2","article-title":"Dual energy CT in musculoskeletal applications beyond crystal imaging: Bone marrow maps and metal artifact reduction","volume":"51","author":"G Cheraya","year":"2022","journal-title":"Skeletal Radiol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"2745","DOI":"10.3390\/diagnostics13172745","article-title":"Detecting Bone Marrow Edema of the Extremities on Spectral Computed Tomography Using a Three-Material Decomposition","volume":"13","author":"M Schierenbeck","year":"2023","journal-title":"Diagnostics"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1186\/s41747-021-00228-y","article-title":"Virtual non-calcium dual-energy CT: Clinical applications","volume":"5","author":"T D\u2019Angelo","year":"2021","journal-title":"Eur Radiol Exp"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"637","DOI":"10.1148\/radiol.2015142631","article-title":"Dual- and Multi-Energy CT: Principles, Technical Approaches, and Clinical Applications","volume":"276","author":"CH McCollough","year":"2015","journal-title":"Radiology"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"2357","DOI":"10.1007\/s00330-020-07320-8","article-title":"Role of computed tomography texture analysis using dual-energy-based bone marrow imaging for multiple myeloma characterization: Comparison with histology and established serologic parameters","volume":"31","author":"CP Reinert","year":"2021","journal-title":"Eur Radiol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","author":"MJ Page","year":"2021","journal-title":"BMJ"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"529","DOI":"10.7326\/0003-4819-155-8-201110180-00009","article-title":"QUADAS-2: A Revised Tool for the Quality Assessment of Diagnostic Accuracy Studies","volume":"155","author":"PF Whiting","year":"2011","journal-title":"Ann Intern Med"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"43","DOI":"10.2478\/raon-2024-0003","article-title":"Quantitative assessment of bone marrow infiltration and characterization of tumor burden using dual-layer spectral CT in patients with multiple myeloma","volume":"58","author":"X Xiong","year":"2024","journal-title":"Radiology and Oncology"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1016\/j.acra.2021.01.029","article-title":"Dual-Energy CT-Based Bone Marrow Imaging in Multiple Myeloma: Assessment of Focal Lesions in Relation to Disease Status and MRI Findings","volume":"29","author":"S Werner","year":"2022","journal-title":"Academic Radiology"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"2345","DOI":"10.21037\/qims-23-1042","article-title":"Detecting bone marrow infiltration in nonosteolytic multiple myeloma through separation of hydroxyapatite via the two-material decomposition technique in spectral computed tomography","volume":"14","author":"J Chen","year":"2024","journal-title":"Quant Imaging Med Surg"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1059","DOI":"10.1007\/s00256-024-04805-1","article-title":"Visual assessment and quantitative analysis of dual-energy CT virtual non-calcium in imaging diagnosis of multiple myeloma","volume":"54","author":"L Liang","year":"2025","journal-title":"Skeletal Radiol"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1148\/radiol.2017170281","article-title":"Multiple Myeloma and Dual-Energy CT: Diagnostic Accuracy of Virtual Noncalcium Technique for Detection of Bone Marrow Infiltration of the Spine and Pelvis","volume":"286","author":"A Kosmala","year":"2018","journal-title":"Radiology"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"W324","DOI":"10.2214\/AJR.14.12613","article-title":"Dual-Energy CT: Virtual Calcium Subtraction for Assessment of Bone Marrow Involvement of the Spine in Multiple Myeloma","volume":"204","author":"C Thomas","year":"2015","journal-title":"American Journal of Roentgenology"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbo.2024.100636","article-title":"Diagnosis of newly developed multiple myeloma without bone disease detectable on conventional computed tomography (CT) scan by using dual-energy CT","volume":"48","author":"N Jiang","year":"2024","journal-title":"Journal of Bone Oncology"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000038003","article-title":"Value of third-generation of VNCa dual-energy CT for differentiating diffuse marrow infiltration of multiple myeloma from red bone marrow","volume":"103","author":"T Wang","year":"2024","journal-title":"Medicine"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"463","DOI":"10.3233\/XST-200811","article-title":"Quantitative evaluation of bone marrow infiltration using dual-energy spectral computed tomography in patients with multiple myeloma","volume":"29","author":"C Hu","year":"2021","journal-title":"Journal of X-Ray Science and Technology: Clinical Applications of Diagnosis and Therapeutics"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"805","DOI":"10.1055\/a-0864-2084","article-title":"Imaging of Multiple Myeloma","volume":"191","author":"A Kosmala","year":"2019","journal-title":"Fortschr R\u00f6ntgenstr"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"5083","DOI":"10.1007\/s00330-018-5537-5","article-title":"Dual-energy CT of the bone marrow in multiple myeloma: Diagnostic accuracy for quantitative differentiation of infiltration patterns","volume":"28","author":"A Kosmala","year":"2018","journal-title":"Eur Radiol"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"7664","DOI":"10.1007\/s00330-021-07821-0","article-title":"Quantitative and qualitative assessment of plasma cell dyscrasias in dual-layer spectral CT","volume":"31","author":"SC Brandelik","year":"2021","journal-title":"Eur Radiol"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2022.110223","article-title":"Correlation between whole skeleton dual energy CT calcium-subtracted attenuation and bone marrow infiltration in multiple myeloma","volume":"149","author":"R Gu","year":"2022","journal-title":"European Journal of Radiology"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2021.734819","article-title":"Radiotherapy Response Assessment of Multiple Myeloma: A Dual-Energy CT Approach With Virtual Non-Calcium Images","volume":"11","author":"P Fervers","year":"2021","journal-title":"Front Oncol"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2020.109214","article-title":"Mid-term response assessment in multiple myeloma using a texture analysis approach on dual energy-CT-derived bone marrow images \u2014 A proof of principle study","volume":"131","author":"CP Reinert","year":"2020","journal-title":"European Journal of Radiology"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"933","DOI":"10.1016\/j.rcl.2023.06.015","article-title":"Dual-Energy Computed Tomography to Photon Counting Computed Tomography: Emerging Technological Innovations","volume":"61","author":"S Srinivas-Rao","year":"2023","journal-title":"Radiologic Clinics of North America"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"1006","DOI":"10.3348\/kjr.2023.0211","article-title":"Impact of Photon-Counting Detector Computed Tomography on Image Quality and Radiation Dose in Patients With Multiple Myeloma","volume":"24","author":"A Rau","year":"2023","journal-title":"Korean J Radiol"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1148\/rycan.220073","article-title":"Prospective Multireader Evaluation of Photon-counting CT for Multiple Myeloma Screening","volume":"4","author":"FR Schwartz","year":"2022","journal-title":"Radiology: Imaging Cancer"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2021.109915","article-title":"3D MRI with CT-like bone contrast \u2013 An overview of current approaches and practical clinical implementation","volume":"143","author":"LR Chong","year":"2021","journal-title":"European Journal of Radiology"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1097\/RLI.0000000000000916","article-title":"Synthetic CT in Musculoskeletal Disorders: A Systematic Review","volume":"58","author":"AF Lombardi","year":"2023","journal-title":"Invest Radiol"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"5310","DOI":"10.1038\/s41598-024-55427-5","article-title":"Opportunistic screening with multiphase contrast-enhanced dual-layer spectral CT for osteoblastic lesions in prostate cancer compared with bone scintigraphy","volume":"14","author":"M-C Liu","year":"2024","journal-title":"Sci Rep"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1007\/s00330-023-10036-0","article-title":"Spectral CT assists differentiation of osteoblastic bone metastasis from bone island in newly diagnosed cancer patients","volume":"34","author":"H Luo","year":"2023","journal-title":"Eur Radiol"}],"container-title":["R\u00f6Fo - Fortschritte auf dem Gebiet der R\u00f6ntgenstrahlen und der bildgebenden Verfahren"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2625-5643.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T15:28:33Z","timestamp":1768231713000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2625-5643"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,23]]},"references-count":33,"journal-issue":{"issue":"01","published-online":{"date-parts":[[2025,12,16]]},"published-print":{"date-parts":[[2026,1]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2625-5643","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["1438-9029","1438-9010"],"issn-type":[{"value":"1438-9029","type":"print"},{"value":"1438-9010","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,23]]}}}