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Comparison of [18F]FDG PET/CT and MRI for Treatment Response Assessment in Multiple Myeloma: A Meta-Analysis
Kota Yokoyama1, Junichi Tsuchiya1, Ukihide Tateishi1
1Department of Diagnostic Radiology, Tokyo Medical and Dental University, Tokyo 113-8510, Japan.
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.
Insights
2-deoxy-2[18F]fluoro-D-glucose (FDG) PET/CT offers superior accuracy over MRI for assessing multiple myeloma treatment response. This imaging technique better detects therapeutic effects and residual disease in patients undergoing treatment.
Area of Science:
- Nuclear Medicine
- Radiology
- Oncology
Background:
- Assessing treatment response in multiple myeloma (MM) is crucial for patient management.
- Magnetic resonance imaging (MRI) is a standard imaging modality, but its accuracy in treatment response assessment can be limited.
- Positron emission tomography/computed tomography (PET/CT) using 2-deoxy-2[18F]fluoro-D-glucose ([18F]FDG) is an emerging technique for oncologic imaging.
Purpose of the Study:
- To evaluate the added diagnostic value of [18F]FDG PET/CT compared to MRI in assessing treatment response in multiple myeloma.
- To quantitatively compare the performance characteristics of [18F]FDG PET/CT and MRI for detecting therapeutic effects and residual disease in treated MM patients.
Main Methods:
- A meta-analysis was conducted on available studies comparing [18F]FDG PET/CT and MRI for MM treatment response assessment.
- Sensitivity, specificity, diagnostic odds ratio (DOR), positive and negative likelihood ratios (LR) were calculated.
- Summary receiver operating characteristic (SROC) curves were generated using hierarchical regression models.
Main Results:
- The pooled analysis included six studies with 278 patients.
- [18F]FDG PET/CT demonstrated higher sensitivity (80%) compared to MRI (25%).
- MRI showed higher specificity (83%) than [18F]FDG PET/CT (58%), but [18F]FDG PET/CT had a better DOR (6.0 vs 1.7) and SROC area under the curve (0.77 vs 0.59).
Conclusions:
- [18F]FDG PET/CT exhibits a superior ability to detect treatment response in multiple myeloma compared to MRI.
- The higher sensitivity and better overall performance metrics of [18F]FDG PET/CT suggest its significant value in managing MM patients.
- Further research may refine the optimal integration of [18F]FDG PET/CT into MM treatment monitoring protocols.
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