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Erschienen in:
01.02.2013 | Nuclear Medicine
Comparative diagnostic performance of 18F-FDG PET/CT versus whole-body MRI for determination of remission status in multiple myeloma after stem cell transplantation
Erschienen in: European Radiology | Ausgabe 2/2013
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Objectives
To compare the diagnostic performance of whole-body magnetic resonance imaging (WBMRI) versus 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) for determination of remission status in patients with multiple myeloma (MM) after stem cell transplantation (SCT).
Methods
Thirty-one patients were examined by both WBMRI and PET/CT after SCT. Imaging results and clinical remission status as determined by the clinical gold standard (Uniform Response Criteria) were compared.
Results
One hundred four lesions were detected in 21 patients. PET/CT had a sensitivity of 50.0 %, a specificity of 85.7 %, a positive predictive value of 62.5 %, a negative predictive value of 78.3 %, and an overall accuracy of 74.2 % for determination of remission status. MRI had a sensitivity of 80.0 %, a specificity of 38.1 %, a positive predictive value of 38.1 %, a negative predictive value of 80 %, and an overall accuracy of 51.6 %. Concordant results were observed in only 12 (11.5 %) of the 104 lesions.
Conclusions
In the post-treatment setting, both FDG PET/CT and WBMRI provide information about the extent of disease, allowing for a more comprehensive evaluation of persisting or recurrent myeloma. MRI may often be false positive because of persistent non-viable lesions. Therefore, PET/CT might be more suitable than MRI for determination of remission status.
Key Points
• Both whole-body MRI and
18
F-FDG PET/CT are now used for assessing multiple myeloma
• Both investigations may visualise residual or recurrent disease after stem cell transplantation
• MRI may give false-positive results because of persistent inactive lesions