Cancer Imaging, Division of Imaging Sciences & Biomedical Engineering, King's College London, United Kingdom; Division of Radiology, Department of Imaging and Medical Information Sciences, Geneva University Hospitals, Geneva, Switzerland.
Cancer Imaging, Division of Imaging Sciences & Biomedical Engineering, King's College London, United Kingdom; Department of Radiology, Guy's & St Thomas' NHS Foundation Trust, London, United Kingdom.
Crit Rev Oncol Hematol. 2018 Apr;124:66-72. doi: 10.1016/j.critrevonc.2018.02.012. Epub 2018 Mar 2.
To undertake a systematic review to determine the diagnostic performance of whole body MRI (WBMRI) including diffusion weighted sequences (DWI) compared to whole body computed tomography (WBCT) or F-fluorodeoxyglucose positron emission tomography/CT (F-FDG PET/CT) in patients with myeloma.
Two researchers searched the primary literature independently for WBMRI studies of myeloma. Data were extracted focusing on the diagnostic ability of WBMRI versus WBCT and F-FDG PET/CT. Meta-analysis was intended.
6 of 2857 articles were eligible that included 147 patients, published from 2008 to 2016. Studies were heterogeneous including both newly diagnosed & relapsed patients. All were single centre studies. Four of the six studies (66.7%) accrued prospectively and 5/6 (83.3%, 3 prospective) included WBMRI and F-FDG PET/CT. Three of seven (42.9%) included DWI. The lack of an independent reference standard for individual lesions was noted in 5/6 (83.3%) studies. Studies reported that WBMRI detected more lesions than F-FDG PET/CT (sensitivity 68-100% versus 47-100%) but was less specific (specificity 37-83% versus 62-85.7%). No paper assessed impact on management.
Studies were heterogeneous, the majority lacking an independent reference standard. Future prospective trials should address these limitations and assess the impact of WBMRI on management.
系统评价全身 MRI（WBMRI）包括弥散加权序列（DWI）与全身 CT（WBCT）或 F-氟代脱氧葡萄糖正电子发射断层扫描/CT（F-FDG PET/CT）相比在骨髓瘤患者中的诊断性能。
两名研究人员独立搜索了骨髓瘤的 WBMRI 研究的初级文献。数据提取重点关注 WBMRI 与 WBCT 和 F-FDG PET/CT 的诊断能力。计划进行荟萃分析。
在 2857 篇文章中，有 6 篇符合条件，包括 147 名患者，发表时间为 2008 年至 2016 年。研究具有异质性，包括新发和复发患者。所有研究均为单中心研究。其中 4 项研究（66.7%）前瞻性募集，5/6 项研究（83.3%，3 项前瞻性）包括 WBMRI 和 F-FDG PET/CT。7 项研究中有 3 项（42.9%）包括 DWI。5/6 项研究（83.3%）指出，个别病变缺乏独立的参考标准。研究报告称，WBMRI 比 F-FDG PET/CT 检测到更多的病变（敏感性 68-100%与 47-100%），但特异性较低（特异性 37-83%与 62-85.7%）。没有一篇论文评估对管理的影响。
研究具有异质性，大多数缺乏独立的参考标准。未来的前瞻性试验应解决这些局限性，并评估 WBMRI 对管理的影响。
