Differentiating diffuse from focal pattern on Computed Tomography in multiple myeloma: Added value of a Radiomics approach

Alberto Stefano Tagliafico, Michele Cea, Federica Rossi, Francesca Valdora, Bianca Bignotti, Giulia Succio, Stefano Gualco, Alessio Conte, Alida Dominietto

Research output: Contribution to journalArticlepeer-review


Purpose: Focal pattern in multiple myeloma (MM) seems to be related to poorer survival and differentiation from diffuse to focal pattern on computed tomography (CT) has inter-reader variability. We postulated that a Radiomic approach could help radiologists in differentiating diffuse from focal patterns on CT. Methods: We retrospectively reviewed imaging data of 70 patients with MM with CT, PET-CT or MRI available before bone marrow transplant. Two general radiologist evaluated, in consensus, CT images to define a focal (at least one lytic lesion >5 mm in diameter) or a diffuse (lesions <5 mm, not osteoporosis) pattern. N = 104 Radiomics features were extracted and evaluated with an open source software. Results: The pathological group included: 22 diffuse and 39 focal patterns. After feature reduction, 9 features were different (p < 0.05) in the diffuse and focal patterns (n = 2/9 features were Shape-based: MajorAxisLength and Sphericity; n = 7/9 were Gray Level Run Length Matrix (Glrlm)). AUC of the Radiologists versus Reference Standard was 0.64 (95 % CI: (0.49–0.78) p = 0.20. AUC of the best 4 features (MajorAxisLength, Median, SizeZoneNonUniformity, ZoneEntropy) were: 0.73 (95 % CI: 0.58–0.88); 0.71 (95 % CI: 0.54–0.88); 0.79 (95 % CI: 0.66–0.92); 0.68 (95 % CI: 0.53–0.83) respectively. Conclusion: A Radiomics approach improves radiological evaluation of focal and diffuse pattern of MM on CT.

Original languageEnglish
Article number108739
JournalEuropean Journal of Radiology
Publication statusPublished - Dec 2019


  • Agreement
  • Computed tomography
  • Feature
  • Multiple myeloma
  • Radiomics

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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