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19.09.2020 | Original Article

Prospective comparison of 18-FDG PET/CT and whole-body diffusion-weighted MRI in the assessment of multiple myeloma

verfasst von: Charles Mesguich, Cyrille Hulin, Valerie Latrabe, Axelle Lascaux, Laurence Bordenave, Elif Hindié, Gerald Marit

Erschienen in: Annals of Hematology | Ausgabe 12/2020

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Abstract

Magnetic resonance imaging (MRI) and ¹⁸F-fluorodeoxyglucose positron emission tomography–computed tomography (¹⁸FDG 18F-FDG PET-CT) are standard procedures for staging multiple myeloma (MM). Diffusion-weighted sequences applied to whole-body MRI (WB-DWI) improve its sensitivity. We compared the number of MM bone focal lesions (FLs) detected by ¹⁸F-FDG PET-CT and WB-DWI and evaluated the diagnostic performance of ¹⁸F-FDG PET-CT for diffuse infiltration. Thirty newly diagnosed MM patients prospectively underwent 18F-FDG PET-CT and WB-DWI. The criteria for skeletal region positivity were ≥ 1 focal bone lesions (FLs) and/or diffuse disease. MRI with the MY-RADS criteria was used as a reference standard for the diagnosis of diffuse infiltration. ¹⁸F-FDG PET-CT and WB-DWI were both interpreted as positive in 28/30 patients with an agreement of 1.00 (95% CI 0.77–1.00) between the two methods. The mean numbers of FLs were 16.7 detected by ¹⁸F-FDG PET-CT and 23.9 detected by WB-DWI (P = 0.028). WB-DWI detected more FLs in the skull (P = 0.001) and spine (P = 0.006). Agreement assessed using the prevalence and bias-corrected kappa index was moderate (0.40–0.60) for the spine, sternum–ribs and upper limbs and substantial (0.60–0.80) for the pelvis and lower limbs. As regards the diagnosis of diffuse bone marrow infiltration, the sensitivity, specificity and accuracy of ¹⁸F-FDG PET-CT were 0.75, 0.79 and 0.77, respectively. Although WB-DWI detected more FLs than did ¹⁸F-FDG PET-CT, there was no difference in the detection of bone disease on a per-patient basis. ¹⁸F-FDG PET-CT showed high performance, including for evaluation of diffuse infiltration.

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Titel: Prospective comparison of 18-FDG PET/CT and whole-body diffusion-weighted MRI in the assessment of multiple myeloma
verfasst von: Charles Mesguich
Cyrille Hulin
Valerie Latrabe
Axelle Lascaux
Laurence Bordenave
Elif Hindié
Gerald Marit
Publikationsdatum: 19.09.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: Annals of Hematology / Ausgabe 12/2020
Print ISSN: 0939-5555
Elektronische ISSN: 1432-0584
DOI: https://doi.org/10.1007/s00277-020-04265-2

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Prospective comparison of 18-FDG PET/CT and whole-body diffusion-weighted MRI in the assessment of multiple myeloma

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