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Comparison of modern and conventional imaging techniques in establishing multiple myeloma‐related bone disease: a systematic review
Author(s) -
Regelink Josien C.,
Minnema Monique C.,
Terpos Evangelos,
Kamphuis Marjolein H.,
Raijmakers Pieter G.,
Pieters – van den Bos Indra C.,
Heggelman Ben G. F.,
Nievelstein RutgerJan,
Otten Rene. H. J.,
Lammeren – Venema Danielle,
Zijlstra Josee M.,
Arens Anne I. J.,
Rooy Jacky W.,
Hoekstra Otto S.,
Raymakers Reinier,
Sonneveld Pieter,
Ostelo Raymond W.,
Zweegman Sonja
Publication year - 2013
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/bjh.12346
Subject(s) - medicine , positron emission tomography , magnetic resonance imaging , radiology , multiple myeloma , nuclear medicine , skull , medical physics , surgery
Summary This systematic review of studies compared magnetic resonance imaging ( MRI ), 18 F ‐fluorodeoxyglucose positron emission tomography ( FDG ‐ PET ), FDG ‐ PET with computerized tomography ( PET ‐ CT ) and CT with whole body X‐Ray ( WBXR ) or (whole body) CT in order to provide evidence‐based diagnostic guidelines in multiple myeloma bone disease. A comprehensive search of 3 bibliographic databases was performed; methodological quality was assessed using Q uality A ssessment of D iagnostic A ccuracy S tudies ( QUADAS ) criteria (score 1–14). Data from 32 directly comparative studies were extracted. The mean QUADAS score was 7·1 (3–11), with quality hampered mainly by a poor description of selection and execution criteria. All index tests had a higher detection rate when compared to WBXR , with up to 80% more lesions detected by the newer imaging techniques; MRI (1·12–1·82) CT (1·04–1·33), PET (1·00–1·58) and PET ‐ CT (1·27–1·45). However, the modern imaging techniques detected fewer lesions in the skull and ribs. In a direct comparison CT and MRI performed equally with respect to detection rate and sensitivity . This systematic review supports the I nternational M yeloma W orking G roup guidelines, which recommend that WBCT can replace WBXR . In our opinion, the equal performance of MRI also indicates that it is a valuable alternative. As lesions of the skull and ribs are underdiagnosed by modern imaging techniques we advise additional X ‐rays of these regions. The consequences of this approach are discussed.