A Systematic Review of MRI, Scintigraphy, FDG-PET and PET/CT for Diagnosis of Multiple Myeloma Related Bone Disease - Which is Best?


Aim: The purpose of the current study was to conduct a systematic review of the published literature toevaluate the diagnostic accuracy of FDG-PET, PTE/CT, MRI and scintigraphy for multiple myeloma relatedbone disease.
Methods: Through a search of PubMed, EMBASE, and the Cochrane Library, two reviewersindependently assessed the methodological quality of each study. We estimated pooled sensitivity, specificity,positive and negative likelihood ratios (PLR and NLR), and two sample Z-tests were conducted to evaluate fordifferences in sensitivity, specificity, area under the curve (AUC), and the Q* index between any two diagnosticmodalities.
Results: A total of 17 studies were reviewed. The MRI had a pooled sensitivity of 0.88, specificity of0.68, AUC of 0.897, and Q*index of 0.828, whereas for MIBI, the corresponding values were 0.98, 0.90, 0.991,and 0.962, respectively, and for bone scan, they were 066, 0.83, 0.805, and 0.740, respectively. The correspondingvalues of MIBI were 0.98, 0.90, 0.991, and 0.962, respectively. For PET and PET/CT, the values were 0.91, 0.69,0.927 and 0.861, respectively. Statistically significant differences were not found in the sensitivity, specificity, AUC,and Q* index between MRI, scintigraphy, FDG-PET and PET/CT.
Conclusions: On the condition that X ray istaken as a reference in our study, we suggested that FDG-PET, PTE/CT, MRI and scintigraphy are all associatedwith high detection rate of bone disease in patients with MM. Thus, in clinical practice, it is recommended thatwe could choose these tests according to the condition of the patient.