Abstract
Numerous imaging modalities are available for the diagnosis of bone metastases (BM) in patients with cancer. This paper reviews published studies comparing whole-body (wb) MRI to BS, PET or PET-CT to provide up-to-date evaluation of the diagnostic accuracy of wbMRI to detect BM. This review is based on a systematic search of the literature of studies evaluating the diagnostic performance of wbMRI for BM detection. Evidence synthesis was achieved via a classification tree, which provides an overview of the performance of the different imaging techniques and of the context in which these are assessed, and an evidence table to seek confirmation of the diagnostic value of the imaging techniques. Eligible studies (n = 23/301) included patients with cancer who underwent wbMRI for suspicion of BM or for systematic cancer staging, compared with at least one other imaging tool. The evidence supporting the superiority of wbMRI over BS for BM screening is strong. wbMRI with diffusion-weighted imaging (DWI) sequence has higher sensitivity than wbMRI alone. The respective accuracies of wbMRI and FDG PET-CT differ depending both on the type of analysis (lesion, region or patient-based) and primary cancer. wbMRI and PET-CT emerge as the techniques of choice for the diagnosis of BM. The inclusion of DWI in wbMRI protocols is of value to optimize the sensitivity but does not add in specificity. This indicates the importance of the anatomical sequences in those protocols. Further comparisons between wbMRI and DWI alone, 18F-NaF, 11C-Choline, PSMA PET-CT and PET-MRI systems remain necessary.
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Abbreviations
- Se:
-
Sensitivity
- Sp:
-
Specificity
- CT:
-
Computed tomography
- MRI:
-
Magnetic resonance imaging
- wbMRI:
-
Whole-body magnetic resonance imaging
- DWI:
-
Diffusion-weighted imaging
- STIR:
-
Short tau inversion recovery
- PET:
-
Positron emission tomography
- SPECT:
-
Single photon emission computed tomography
- BS:
-
Bone scintigraphy
- BM:
-
Bone metastases
- SD:
-
Statistical difference between capability (Se/Sp) values assessed at a standard p value <0.05
- bSD:
-
Statistical difference between capability values assessed at a p value compliant with Bonferroni’s correction
- nsSD:
-
Statistical difference between capability values superior or equal to 5 % assessed qualitatively or reported to be statistically non-significant (p > 0.05)
- Eq:
-
Statistical difference between capability values inferior to 5 % assessed qualitatively or reported to be statistically non-significant (p > 0.05)
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Supported by Grants from the Belgian non-profit organizations FRS-FNRS Télévie, Fondation Contre le Cancer and Fondation Saint Luc to VP and FEL
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V. Pasoglou, N. Michoux, B. Tombal, F. Jamar, F.E. Lecouvet declare no conflict of interest.
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V. Pasoglou and N. Michoux contributed equally to this work.
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Pasoglou, V., Michoux, N., Tombal, B. et al. wbMRI to detect bone metastases: critical review on diagnostic accuracy and comparison to other imaging modalities. Clin Transl Imaging 3, 141–157 (2015). https://doi.org/10.1007/s40336-015-0120-4
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DOI: https://doi.org/10.1007/s40336-015-0120-4