Comparison of the diagnostic performance and impact on management of 18F-FDG PET/CT and whole-body MRI in multiple myeloma.
18F-fluorodeoxyglucose positron emission tomography computed tomography
Diagnosis
Myeloma
Whole-body magnetic resonance imaging
Journal
European journal of nuclear medicine and molecular imaging
ISSN: 1619-7089
Titre abrégé: Eur J Nucl Med Mol Imaging
Pays: Germany
ID NLM: 101140988
Informations de publication
Date de publication:
07 2021
07 2021
Historique:
received:
04
08
2020
accepted:
27
12
2020
pubmed:
21
1
2021
medline:
13
7
2021
entrez:
20
1
2021
Statut:
ppublish
Résumé
Comparative data on the impact of imaging on management is lacking for multiple myeloma. This study compared the diagnostic performance and impact on management of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) and whole-body magnetic resonance imaging (WBMRI) in treatment-naive myeloma. Forty-six patients undergoing 18F-FDG PET/CT and WBMRI were reviewed by a nuclear medicine physician and radiologist, respectively, for the presence of myeloma bone disease. Blinded clinical and imaging data were reviewed by two haematologists in consensus and management recorded following clinical data ± 18F-FDG PET/CT or WBMRI. Bone disease was defined using International Myeloma Working Group (IMWG) criteria and a clinical reference standard. Per-patient sensitivity for lesion detection was established. McNemar test compared management based on clinical assessment ± 18F-FDG PET/CT or WBMRI. Sensitivity for bone lesions was 69.6% (32/46) for 18F-FDG PET/CT (54.3% (25/46) for PET component alone) and 91.3% (42/46) for WBMRI. 27/46 (58.7%) of cases were concordant. In 19/46 patients (41.3%) WBMRI detected more focal bone lesions than 18F-FDG PET/CT. Based on clinical data alone, 32/46 (69.6%) patients would have been treated. Addition of 18F-FDG PET/CT to clinical data increased this to 40/46 (87.0%) patients (p = 0.02); and WBMRI to clinical data to 43/46 (93.5%) patients (p = 0.002). The difference in treatment decisions was not statistically significant between 18F-FDG PET/CT and WBMRI (p = 0.08). Compared to 18F-FDG PET/CT, WBMRI had a higher per patient sensitivity for bone disease. However, treatment decisions were not statistically different and either modality would be appropriate in initial staging, depending on local availability and expertise.
Identifiants
pubmed: 33469686
doi: 10.1007/s00259-020-05182-2
pii: 10.1007/s00259-020-05182-2
pmc: PMC8241666
mid: EMS119963
doi:
Substances chimiques
Radiopharmaceuticals
0
Fluorodeoxyglucose F18
0Z5B2CJX4D
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
2558-2565Subventions
Organisme : Cancer Research UK
ID : C1519/A16463
Pays : United Kingdom
Organisme : Cancer Research UK
ID : A16463
Pays : United Kingdom
Organisme : Wellcome Trust
ID : 203148
Pays : United Kingdom
Organisme : Wellcome Trust
ID : WT 203148/Z/16/Z
Pays : United Kingdom
Organisme : Wellcome Trust
Pays : United Kingdom
Investigateurs
Joanna Bell
(J)
Isabel Dregely
(I)
Adrian Green
(A)
Renyang Gu
(R)
Ulrike Haberland
(U)
Sami Jeljeli
(S)
Majid Kazmi
(M)
Nessa Muhidun
(N)
Sarah Natas
(S)
Radhouene Neji
(R)
Francesco Padormo
(F)
John Spence
(J)
J James Stirling
(JJ)
Manil Subesinghe
(M)
Hema Verma
(H)
Zaid Viney
(Z)
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