Comparative diagnostic performance of ¹⁸F-FDG PET/CT versus whole-body MRI for determination of remission status in multiple myeloma after stem cell transplantation

Eur Radiol. 2013 Feb;23(2):570-8. doi: 10.1007/s00330-012-2600-5. Epub 2012 Jul 29.

Abstract

Objectives: To compare the diagnostic performance of whole-body magnetic resonance imaging (WBMRI) versus (18)F-fluorodeoxyglucose ((18)F-FDG) positron emission tomography/computed tomography (PET/CT) for determination of remission status in patients with multiple myeloma (MM) after stem cell transplantation (SCT).

Methods: Thirty-one patients were examined by both WBMRI and PET/CT after SCT. Imaging results and clinical remission status as determined by the clinical gold standard (Uniform Response Criteria) were compared.

Results: One hundred four lesions were detected in 21 patients. PET/CT had a sensitivity of 50.0 %, a specificity of 85.7 %, a positive predictive value of 62.5 %, a negative predictive value of 78.3 %, and an overall accuracy of 74.2 % for determination of remission status. MRI had a sensitivity of 80.0 %, a specificity of 38.1 %, a positive predictive value of 38.1 %, a negative predictive value of 80 %, and an overall accuracy of 51.6 %. Concordant results were observed in only 12 (11.5 %) of the 104 lesions.

Conclusions: In the post-treatment setting, both FDG PET/CT and WBMRI provide information about the extent of disease, allowing for a more comprehensive evaluation of persisting or recurrent myeloma. MRI may often be false positive because of persistent non-viable lesions. Therefore, PET/CT might be more suitable than MRI for determination of remission status.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Cohort Studies
  • Confidence Intervals
  • Disease-Free Survival
  • Female
  • Fluorodeoxyglucose F18*
  • Follow-Up Studies
  • Graft Survival
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Multimodal Imaging / methods*
  • Multiple Myeloma / diagnosis*
  • Multiple Myeloma / surgery*
  • Neoplasm Staging
  • Positron-Emission Tomography*
  • Postoperative Care / methods
  • Predictive Value of Tests
  • Stem Cell Transplantation / adverse effects
  • Stem Cell Transplantation / methods*
  • Survival Analysis
  • Time Factors
  • Tomography, X-Ray Computed*
  • Treatment Outcome

Substances

  • Fluorodeoxyglucose F18