Abstract
The present study was designed to assess the additional value of 2-deoxy-2[18F]fluoro-D-glucose ([18F]FDG) positron emission tomography/computed tomography (PET/CT) to magnetic resonance imaging (MRI) in the treatment response assessment of multiple myeloma (MM). We performed a meta-analysis of all available studies to compare the detectability of treatment response of [18F]FDG PET/CT and MRI in treated MM. We defined detecting a good therapeutic effect as positive, and residual disease as negative. We determined the sensitivities and specificities across studies, calculated the positive and negative likelihood ratios (LR), and made summary receiver operating characteristic curves (SROC) using hierarchical regression models. The pooled analysis included six studies that comprised 278 patients. The respective performance characteristics (95% confidence interval (CI)) of [18F]FDG PET/CT and MRI were as follows: sensitivity of 80% (56% to 94%) and 25% (19% to 31%); specificity of 58% (44% to 71%) and 83% (71% to 91%); diagnostic odds ratio (DOR) of 6.0 (3.0–12.0) and 1.7 (0.7–2.7); positive LR of 1.8 (1.3–2.4) and 1.4 (0.7–2.7); and negative LR of 0.33 (0.21–0.53) and 0.81 (0.62–1.1). In the respective SROC curves, the area under the curve was 0.77 (SE, 0.038) and 0.59 (SE, 0.079) and the Q* index was 0.71 and 0.57. Compared with MRI, [18F]FDG PET/CT had higher sensitivity and better DOR and SROC curves. Compared with MRI, [18F]FDG PET/CT had greater ability to detect the treatment assessment of MM.
Highlights
Multiple myeloma (MM) is the second most common hematologic cancer, and frequently develops in the elderly, with 65 years as the median age at diagnosis
It is characterized by the proliferation of plasma cells that produce abnormal monoclonal immunoglobulin, which infiltrates the bone marrow (BM), and by the excessive production of monoclonal immunoglobulins that can be detected in serum and/or urine [1]
The inclusion criteria were made based upon the Patient/Intervention/Comparator/ Outcome/Study design (PICOS) criteria [21] as follows: (1) “patients” with MM that were given treatment, such as chemotherapy and/or stem cell transplantation (SCT), (2) [18F]FDG PET or PET/computed tomography (CT) for the treatment response assessment or surveillance after treatment as the “intervention,” (3) magnetic resonance imaging (MRI) as the “comparator”, (4) detection of treatment response with International Myeloma Working Group (IMWG) Uniform Response Criteria for Multiple Myeloma as “outcomes,” and (5) the “study design” included prospective or retrospective studies published as original articles or brief communications
Summary
Multiple myeloma (MM) is the second most common hematologic cancer, and frequently develops in the elderly, with 65 years as the median age at diagnosis. Many studies have shown higher sensitivity for the detection of focal lesions with whole-body computed tomography (CT), 2-deoxy-2[18F]fluoro-D-glucose ([18F]FDG) positron emission tomography/computed tomography (PET/CT) and whole-body magnetic resonance imaging (MRI) than with conventional radiographic skeletal surveys. [18F]FDG PET/CT has been recognized as a sensitive tool to assess the extent of both BM involvement and EMD in newly diagnosed MM [8,9,10] Both MRI and [18F]FDG PET/CT upon diagnosis and during follow-up have been shown to be of prognostic value for progression-free survival (PFS) and/or overall survival (OS) [7,11]. The present study was designed to perform a meta-analysis of all available studies and to assess the advantage of additional [18F]FDG PET/CT over MRI in the treatment response assessment in MM
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
