HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Shortt, C. P. Articles by Eustace, S. J. Search for Related Content PubMed PubMed Citation Articles by Shortt, C. P. Articles by Eustace, S. J. Social Bookmarking                      What's this? Hotlight (NEW!) What's Hotlight?

Whole-Body MRI Versus PET in Assessment of Multiple Myeloma Disease Activity

¹ Department of Radiology and Diagnostic Imaging, Mater Misericordiae University Hospital, Dublin, Ireland.
² Department of Radiology, Cappagh National Orthopaedic Hospital, Dublin, Ireland.
³ Present address: Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St., 1 Silverstein Bldg., Philadelphia, PA 19104.
⁴ Present address: Radiology Department, Vancouver Hospital and Health Sciences Centre, Vancouver, BC, Canada.
⁵ Department of Haematology, Mater Misericordiae University Hospital, Dublin, Ireland.
⁶ Present address: Department of Haematology, St James's Hospital, Dublin, Ireland.

OBJECTIVE. The purpose of this study was to compare FDG PET; whole-body MRI; and the reference standard, bone marrow aspiration and biopsy, to determine the best imaging technique for assessment of disease activity in multiple myeloma.

SUBJECTS AND METHODS. Twenty-four patients (13 women, 11 men; mean age, 67.1 years; range, 44–83 years) with bone marrow biopsy–proven multiple myeloma were included in the study. All patients underwent PET/CT and whole-body MRI within 10 days of each other. Eight patients underwent more than one follow-up PET/CT and whole-body MRI examination, for a total of 34 pairs of images. Activity was defined as lesions with a maximum standardized uptake value greater than 2.5 at PET and as evidence of marrow packing at whole-body MRI. PET and whole-body MRI results were correlated with findings at bone marrow aspiration biopsy.

RESULTS. PET had a sensitivity of 59%, specificity of 75%, positive predictive value of 81%, and negative predictive value of 50% (p = 0.08). Whole-body MRI had a sensitivity of 68%, specificity of 83%, positive predictive value of 88%, and negative predictive value of 59% (p = 0.01). In 62% of cases, PET and whole-body MRI findings were concordant. When PET and whole-body MRI findings were concordant and positive, no false-positive results were found, yielding a specificity and a positive predictive value of 100% (p = 0.04).

CONCLUSION. Whole-body MRI performed better than PET in the assessment of disease activity, having a higher sensitivity and specificity. The positive predictive value of whole-body MRI in the assessment of active disease was high at 88%. When used in combination and with concordant findings, PET and whole-body MRI were found to have a specificity and positive predictive value of 100%, which may be of value to clinicians assessing the effectiveness of aggressive and expensive treatment regimens.

Keywords: emission-computed • MRI • multiple myeloma • positron emission • tomography • total body

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?