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MRI versus 18F-FDG-PET/CT for detecting bone marrow involvement in multiple myeloma: diagnostic performance and clinical relevance.

Abstract：

PURPOSE:To compare the diagnostic performance of MRI and 18F-FDG-PET/CT in detecting bone marrow involvement (BMI) in patients with multiple myeloma (MM). MATERIALS AND METHODS:This retrospective study was approved by our Institutional Review Board. Two radiologists and two nuclear medicine specialists independently and blindly reviewed 84 pairs of MRI and PET/CT scans obtained in 73 MM patients. Readers assessed the presence and patterns of BMI. The best valuable comparator (BVC) for BMI was established by a panel review of all baseline and follow-up imaging, and biological and pathological information. Intra- and inter-reader agreement and correlation between MRI and PET/CT were assessed using the prevalence-adjusted bias-adjusted kappa (k) coefficient. Diagnostic performance of MRI and PET/CT in detecting BMI was evaluated from ROC characteristics. Association between imaging and biological, pathological, and clinical findings was assessed using Wilcoxon rank-sum and chi-square tests. RESULTS:Intra- and inter-reader agreement was very good for MRI (k = 0.90 [0.81; 1.00] and 0.88 [0.78; 0.98]). Intra- and inter-reader agreement was good for PET/CT (k = 0.80 [0.69; 0.91] and 0.71 [0.56; 0.86]). The sensitivity of MRI to detect BMI (97% [90%; 100%]) was significantly superior to that of PET/CT (76% [64%; 85%]) (p < 0.001). The specificity of MRI (86% [57%; 98%]) was lower than that of PET/CT (93% [66%; 100%]), without reaching statistical significance (p = 0.32). There was a strong correlation between decisions regarding patient management and PET/CT findings (p < 0.001). CONCLUSION:MRI is significantly more sensitive than PET/CT to detect BMI in MM. Patient management is more strongly correlated with PET/CT findings. KEY POINTS:• MRI and PET/CT have very close diagnostic value for the detection of bone marrow involvement in multiple myeloma. • MRI has a significantly higher sensitivity and better reproducibility. • PET/CT findings appear to have a higher impact on clinical decisions.

journal_name

Eur Radiol

journal_title

European radiology

authors

Lecouvet FE,Boyadzhiev D,Collette L,Berckmans M,Michoux N,Triqueneaux P,Pasoglou V,Jamar F,Vekemans MC

doi

10.1007/s00330-019-06469-1

subject

Has Abstract

pub_date

2020-04-01 00:00:00

pages

1927-1937

issue

eissn

0938-7994

issn

1432-1084

pii

10.1007/s00330-019-06469-1

journal_volume

pub_type

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MRI versus 18F-FDG-PET/CT for detecting bone marrow involvement in multiple myeloma: diagnostic performance and clinical relevance.