Mickael Tordjman, Murat Yuce, Amine Geahchan, Giuseppe Petralia, Roberto C Delgado Bolton, Katherine Wang, Amish H Doshi, Ian Bolger, Xueyan Mei, Laurent Dercle, Himanshu Joshi, Christina Messiou, Dow-Mu Koh, Samir Parekh, Bachir Taouli
{"title":"MRI、[18F]FDG-PET/CT和[18F]FDG-PET/MRI对多发性骨髓瘤初始分期的比较：一项系统综述和meta分析。","authors":"Mickael Tordjman, Murat Yuce, Amine Geahchan, Giuseppe Petralia, Roberto C Delgado Bolton, Katherine Wang, Amish H Doshi, Ian Bolger, Xueyan Mei, Laurent Dercle, Himanshu Joshi, Christina Messiou, Dow-Mu Koh, Samir Parekh, Bachir Taouli","doi":"10.1097/RLU.0000000000006048","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>This systematic review and meta-analysis compared the diagnostic performance of MRI, [ 18 F]FDG-PET/CT, and [ 18 F]FDG-PET/MRI in detecting focal bone lesions and bone marrow infiltration in the initial staging of patients with multiple myeloma (MM) who underwent both MRI and [ 18 F]FDG-PET/CT or [ 18 F]FDG-PET/MRI studies.</p><p><strong>Patients and methods: </strong>A systematic literature search was conducted across PubMed, Embase, and Cochrane databases, including studies comparing the performance of MRI (WB-MRI or spine/pelvis MRI), [ 18 F]FDG-PET/CT, and/or [ 18 F]FDG-PET/MRI in the same patients for MM initial staging. Pooled sensitivities and concordance between imaging modalities were analyzed using R (package META-R). Heterogeneity and bias were assessed with the QUADAS-C tool.</p><p><strong>Results: </strong>Twenty studies (published between 2007 and 2025) using the international MM diagnostic criteria as a reference standard met the inclusion criteria. Of these, 13 (n=742) compared per-patient sensitivity of [ 18 F]FDG-PET/CT and MRI, and 4 (n=224) compared MRI and [ 18 F]FDG-PET/MRI. Pooled sensitivities were 0.807 (95% CI: 0.74-0.86) for [ 18 F]FDG-PET/CT (with significant heterogeneity) versus 0.914 (95% CI: 0.88-0.94) for MRI (0.906 for spine/pelvis MRI and 0.920 for WB-MRI) ( P <0.001 for meta-regression analysis). Using contingency tables, 83% (599/721) of included patients had concordant [ 18 F]FDG-PET/CT and MRI results, while 14% (101/721) patients had negative [ 18 F]FDG-PET/CT and positive MRI with significant differences between the 2 techniques for the paired sample analysis ( P <0.001). The pooled sensitivity of the 4 studies including [ 18 F]FDG-PET/MRI was 0.944 (95% CI: 0.88-0.98). Consensus definitions for specificity in MM imaging should be standardized across studies.</p><p><strong>Conclusions: </strong>This systematic review and comparative meta-analysis demonstrates superior sensitivity of WB-MRI compared with [ 18 F]FDG-PET/CT for initial staging of MM patients. Future international guidelines might prioritize MRI and [ 18 F]FDG-PET/MRI for staging of MM patients.</p><p><strong>Registration: </strong>PROSPERO CRD42024564937.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":"1006-1015"},"PeriodicalIF":9.6000,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparison of MRI, [ 18 F]FDG-PET/CT, and [ 18 F]FDG-PET/MRI for Initial Staging of Multiple Myeloma : A Systematic Review and Meta-analysis.\",\"authors\":\"Mickael Tordjman, Murat Yuce, Amine Geahchan, Giuseppe Petralia, Roberto C Delgado Bolton, Katherine Wang, Amish H Doshi, Ian Bolger, Xueyan Mei, Laurent Dercle, Himanshu Joshi, Christina Messiou, Dow-Mu Koh, Samir Parekh, Bachir Taouli\",\"doi\":\"10.1097/RLU.0000000000006048\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>This systematic review and meta-analysis compared the diagnostic performance of MRI, [ 18 F]FDG-PET/CT, and [ 18 F]FDG-PET/MRI in detecting focal bone lesions and bone marrow infiltration in the initial staging of patients with multiple myeloma (MM) who underwent both MRI and [ 18 F]FDG-PET/CT or [ 18 F]FDG-PET/MRI studies.</p><p><strong>Patients and methods: </strong>A systematic literature search was conducted across PubMed, Embase, and Cochrane databases, including studies comparing the performance of MRI (WB-MRI or spine/pelvis MRI), [ 18 F]FDG-PET/CT, and/or [ 18 F]FDG-PET/MRI in the same patients for MM initial staging. Pooled sensitivities and concordance between imaging modalities were analyzed using R (package META-R). Heterogeneity and bias were assessed with the QUADAS-C tool.</p><p><strong>Results: </strong>Twenty studies (published between 2007 and 2025) using the international MM diagnostic criteria as a reference standard met the inclusion criteria. Of these, 13 (n=742) compared per-patient sensitivity of [ 18 F]FDG-PET/CT and MRI, and 4 (n=224) compared MRI and [ 18 F]FDG-PET/MRI. Pooled sensitivities were 0.807 (95% CI: 0.74-0.86) for [ 18 F]FDG-PET/CT (with significant heterogeneity) versus 0.914 (95% CI: 0.88-0.94) for MRI (0.906 for spine/pelvis MRI and 0.920 for WB-MRI) ( P <0.001 for meta-regression analysis). Using contingency tables, 83% (599/721) of included patients had concordant [ 18 F]FDG-PET/CT and MRI results, while 14% (101/721) patients had negative [ 18 F]FDG-PET/CT and positive MRI with significant differences between the 2 techniques for the paired sample analysis ( P <0.001). The pooled sensitivity of the 4 studies including [ 18 F]FDG-PET/MRI was 0.944 (95% CI: 0.88-0.98). Consensus definitions for specificity in MM imaging should be standardized across studies.</p><p><strong>Conclusions: </strong>This systematic review and comparative meta-analysis demonstrates superior sensitivity of WB-MRI compared with [ 18 F]FDG-PET/CT for initial staging of MM patients. Future international guidelines might prioritize MRI and [ 18 F]FDG-PET/MRI for staging of MM patients.</p><p><strong>Registration: </strong>PROSPERO CRD42024564937.</p>\",\"PeriodicalId\":10692,\"journal\":{\"name\":\"Clinical Nuclear Medicine\",\"volume\":\" \",\"pages\":\"1006-1015\"},\"PeriodicalIF\":9.6000,\"publicationDate\":\"2025-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Nuclear Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/RLU.0000000000006048\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/7/8 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Nuclear Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/RLU.0000000000006048","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/7/8 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
Comparison of MRI, [ 18 F]FDG-PET/CT, and [ 18 F]FDG-PET/MRI for Initial Staging of Multiple Myeloma : A Systematic Review and Meta-analysis.
Purpose: This systematic review and meta-analysis compared the diagnostic performance of MRI, [ 18 F]FDG-PET/CT, and [ 18 F]FDG-PET/MRI in detecting focal bone lesions and bone marrow infiltration in the initial staging of patients with multiple myeloma (MM) who underwent both MRI and [ 18 F]FDG-PET/CT or [ 18 F]FDG-PET/MRI studies.
Patients and methods: A systematic literature search was conducted across PubMed, Embase, and Cochrane databases, including studies comparing the performance of MRI (WB-MRI or spine/pelvis MRI), [ 18 F]FDG-PET/CT, and/or [ 18 F]FDG-PET/MRI in the same patients for MM initial staging. Pooled sensitivities and concordance between imaging modalities were analyzed using R (package META-R). Heterogeneity and bias were assessed with the QUADAS-C tool.
Results: Twenty studies (published between 2007 and 2025) using the international MM diagnostic criteria as a reference standard met the inclusion criteria. Of these, 13 (n=742) compared per-patient sensitivity of [ 18 F]FDG-PET/CT and MRI, and 4 (n=224) compared MRI and [ 18 F]FDG-PET/MRI. Pooled sensitivities were 0.807 (95% CI: 0.74-0.86) for [ 18 F]FDG-PET/CT (with significant heterogeneity) versus 0.914 (95% CI: 0.88-0.94) for MRI (0.906 for spine/pelvis MRI and 0.920 for WB-MRI) ( P <0.001 for meta-regression analysis). Using contingency tables, 83% (599/721) of included patients had concordant [ 18 F]FDG-PET/CT and MRI results, while 14% (101/721) patients had negative [ 18 F]FDG-PET/CT and positive MRI with significant differences between the 2 techniques for the paired sample analysis ( P <0.001). The pooled sensitivity of the 4 studies including [ 18 F]FDG-PET/MRI was 0.944 (95% CI: 0.88-0.98). Consensus definitions for specificity in MM imaging should be standardized across studies.
Conclusions: This systematic review and comparative meta-analysis demonstrates superior sensitivity of WB-MRI compared with [ 18 F]FDG-PET/CT for initial staging of MM patients. Future international guidelines might prioritize MRI and [ 18 F]FDG-PET/MRI for staging of MM patients.
期刊介绍：
Clinical Nuclear Medicine is a comprehensive and current resource for professionals in the field of nuclear medicine. It caters to both generalists and specialists, offering valuable insights on how to effectively apply nuclear medicine techniques in various clinical scenarios. With a focus on timely dissemination of information, this journal covers the latest developments that impact all aspects of the specialty.
Geared towards practitioners, Clinical Nuclear Medicine is the ultimate practice-oriented publication in the field of nuclear imaging. Its informative articles are complemented by numerous illustrations that demonstrate how physicians can seamlessly integrate the knowledge gained into their everyday practice.
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