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Comparison of MRI, [18F]FDG-PET/CT, and [18F]FDG-PET/MRI for Initial Staging of Multiple Myeloma: A Systematic Review and Meta-analysis

  • 0Department of Diagnostic, Molecular and Interventional Radiology, Biomedical Engineering & Imaging Institute, Mount Sinai Health System, New York, NY.
Clinical Nuclear Medicine +

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July 11, 2025

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July 11, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Whole-body MRI (WB-MRI) shows higher sensitivity than [18F]FDG-PET/CT for initial staging of multiple myeloma (MM). Future guidelines may favor MRI and [18F]FDG-PET/MRI for MM staging.

Area Of Science

  • Oncology
  • Radiology
  • Medical Imaging

Background

  • Accurate initial staging is crucial for multiple myeloma (MM) patient management.
  • Diagnostic performance of various imaging modalities for MM staging requires comprehensive comparison.

Purpose Of The Study

  • To compare the diagnostic performance of MRI, [18F]FDG-PET/CT, and [18F]FDG-PET/MRI in detecting bone lesions and marrow infiltration in newly diagnosed MM patients.
  • To evaluate the sensitivity and concordance of these imaging techniques for initial MM staging.

Main Methods

  • Systematic literature search of PubMed, Embase, and Cochrane databases.
  • Meta-analysis of pooled sensitivities and concordance between MRI (WB-MRI or spine/pelvis MRI), [18F]FDG-PET/CT, and [18F]FDG-PET/MRI.
  • Assessment of heterogeneity and bias using the QUADAS-C tool.

Main Results

  • MRI demonstrated superior pooled sensitivity (0.914) compared to [18F]FDG-PET/CT (0.807) for MM staging.
  • [18F]FDG-PET/MRI showed high pooled sensitivity (0.944).
  • Concordant results between [18F]FDG-PET/CT and MRI were observed in 83% of patients, with significant discordance in 14% favoring MRI.

Conclusions

  • Whole-body MRI (WB-MRI) offers superior sensitivity over [18F]FDG-PET/CT for initial MM staging.
  • MRI and [18F]FDG-PET/MRI are recommended for consideration in future international MM staging guidelines.

Keywords:

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