Diagnostic Value of Whole-Body Diffusion Magnetic Resonance Imaging (WBD-MRI) in Comparison with PET/CT in Assessment of Multiple Myeloma and Bone Metastasis
Keywords:
Magnetic Resonance Imaging, Positron Emission Tomography–Computed Tomography, Multiple Myeloma, Bone MetastasisAbstract
Background: Diffusion weighted imaging-Magnetic Resonance Imaging (DWI-MRI) is a functional MRI technique measuring movement of water molecules within tissue. While positron emission tomography computed tomography (PET/CT) is a functional imaging modality reflecting metabolic activity, increase uptake of the radiotracer 18F- fluorodeoxyglucose (FDG) is indicative of viable bone marrow lesion of myeloma and bone metastasis. The aim of this work was to assess diagnostic value of whole-body diffusion (WBD) MRI in comparison to FDG PET/CT in detection diffuse and focal bone marrow involvement of multiple myeloma (MM), as well as bone metastasis.
Methods: This prospective study was carried out on 62 patients, 38 patients with MM confirmed by bone marrow aspiration and 24 primary malignancy and metastatic bony lesions.
Results: PET/CT can predict MM in skull, thoracic cage, pelvis, spine and long bone respectively (P= 1, 1, 0.625, 1 and 1) with sensitivity 60%, 75%, 66.7%, 85.7% and 66.7%, specificity 66.7%, 66.7%, 66.7%, 66.7% and 50%. In comparison between PET/CT and MRI- WBD, MRI-WBD is better than PET/CT in detection of MM bone marrow lesions and metastatic bony lesions with sensitivity, accuracy, negative and positive predictive value, but have the same specificity.
Conclusions: Whole body MRI-DWI and apparent diffusion coefficient values significantly improve the diagnostic accuracy in detection of MM bone marrow lesions and bone metastatic lesions, with relatively higher sensitivity and accuracy than PET/CT study. WBD-MRI seems to be a promising method of imaging in the detection of MM and bone metastasis. Standardization of these protocols is needed
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