Zhang Bei, Zhang Li, Bian Bingyang, Lin Fang, Zhu Zining, Wang Jiping
Department of Radiology, First Hospital of Jilin University, Changchun, China.
Indian J Cancer. 2023 Jul-Sep;60(3):303-309. doi: 10.4103/ijc.IJC_1129_20.
Whole-body diffusion-weighted imaging (WB-DWI) is commonly used for the detection of multiple myeloma (MM). Comparative data on the efficiency of WB-DWI compared with F-18 fluoro-2-deoxy-d-glucose positron emission tomography-computed tomography (F-FDG PET/CT) to detect MM is limited.
This was a retrospective, single-center study of 22 patients with MM enrolled from January 2018 to December 2019. All patients underwent WB-DWI and F-FDG PET/CT. Pathological and clinical manifestations, as well as radiologic follow-up, were used for diagnosis. The overall accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of both methods were compared. The apparent diffusion coefficient (ADC) values of MM lesions and false-positive lesions were estimated.
A total of 214 MM bone lesions were evaluated. There was no significant difference in the accuracy of WB-DWI and PET/CT (86.92 versus 88.32%). Though WB-DWI had a higher sensitivity (99.26% versus84.56%) and PET-CT had a higher specificity (96.10% versus 64.56%), these differences were not statistically significant. There was a statistically significant difference in PPV (83.33% versus 96.64%) and NPV (98.08% versus 77.89%) of WB-DWI and PET/CT, respectively. The ADC value for MM lesions was significantly lower than that for false-positive lesions (P < 0.001). Receiver operating curve analysis showed that the AUC was 0.846, and when the cut-off value was 0.745 × 10 mm/s, the sensitivity and specificity were 86.3 and 83.4%, respectively, which distinguished MM lesions from non-MM lesions.
WB-DWI and PET-CT scans have similar overall accuracy for detecting MM lesions. The higher PPV of PET-CT and NPV of WB-DWI make them complementary imaging modalities. The ADC value for MM lesions is significantly lower than that for false-positive lesions. An ADC cutoff value of 0.745 × 10 mm/s results in sensitivity and specificity of 86.3 and 83.4%, respectively.
全身扩散加权成像（WB-DWI）常用于检测多发性骨髓瘤（MM）。与F-18氟代脱氧葡萄糖正电子发射断层扫描-计算机断层扫描（F-FDG PET/CT）相比，WB-DWI检测MM效率的对比数据有限。
这是一项回顾性单中心研究，纳入了2018年1月至2019年12月期间的22例MM患者。所有患者均接受了WB-DWI和F-FDG PET/CT检查。采用病理及临床表现以及影像学随访结果进行诊断。比较了两种方法的总体准确性、敏感性、特异性、阳性预测值和阴性预测值。估算了MM病灶及假阳性病灶的表观扩散系数（ADC）值。
共评估了214个MM骨病灶。WB-DWI与PET/CT的准确性无显著差异（86.92%对88.32%）。虽然WB-DWI具有更高的敏感性（99.26%对84.56%），PET-CT具有更高的特异性（96.10%对64.56%），但这些差异无统计学意义。WB-DWI和PET/CT的阳性预测值（83.33%对96.64%）和阴性预测值（98.08%对77.89%）分别存在统计学差异。MM病灶的ADC值显著低于假阳性病灶（P<0.001）。受试者工作特征曲线分析显示，曲线下面积为0.846，当截断值为0.745×10⁻³mm²/s时，敏感性和特异性分别为86.3%和83.4%，可区分MM病灶与非MM病灶。
WB-DWI和PET-CT扫描在检测MM病灶方面总体准确性相似。PET-CT较高的阳性预测值和WB-DWI较高的阴性预测值使其成为互补的成像方式。MM病灶的ADC值显著低于假阳性病灶。ADC截断值为0.745×10⁻³mm²/s时，敏感性和特异性分别为86.3%和83.4%。
