Whole-Body MRI vs. PET/CT for the Detection of Bone Metastases in Patients With Prostate Cancer: A Systematic Review and Meta-Analysis.

A recent meta-analysis in patients with non-small cell lung cancer showed no difference between whole-body magnetic resonance imaging (WBMRI) and positron emission tomography/computed tomography (PET/CT), but no such study is available for prostate cancer (PCa). This study aimed to compare WBMRI and PET/CT for bone metastasis detection in patients with PCa. PubMed, Embase, and the Cochrane library were searched for papers published up to April 2020. The population was the patients with untreated prostate cancer diagnosed by WBMRI or PET/CT. The outcomes were the true positive and negative and false positive and negative rates for WBMRI and PET/CT. The summarized sensitivity, specificity, positive likelihood ratios (PLR), negative likelihood ratios (NLR), and diagnostic odds ratios (DOR) were calculated with their 95% confidence intervals (CIs). Four prospective and one retrospective study are included (657 patients). Significant differences are observed between WBMRI and PET/CT for sensitivity (WBMRI/PET/CT: 0.896; 95% CI: 0.813-0.987; = 0.025) and NLR (WBMRI/PET/CT: 2.38; 95% CI: 1.13-5.01; = 0.023), but not for specificity (WBMRI/PET/CT: 0.939; 95% CI: 0.855-1.031; = 0.184) and PLR (WBMRI/PET/CT: 0.42; 95% CI: 0.08-2.22; = 0.305). WBMRI has a similar a DOR compared with PET/CT (WBMRI/PET/CT: 0.13; 95% CI: 0.02-1.11; = 0.062). The summary area under the receiver operating characteristic curves for WBMRI is 0.88 (standard error: 0.032) and 0.98 (standard error: 0.013) for PET/CT for diagnosing bone metastases in PCa. PET/CT presents a higher sensitivity and NLR for the bone metastasis detection from PCa, whereas no differences are found for specificity and PLR, compared with WBMRI.