Comparison of 18-FDG PET/CT and Whole-Body Diffusion-Weighted MRI in Staging Multiple Myeloma

A study shows that 18F-fluorodeoxyglucose positron emission tomography-computed tomography (18FDG 18F-FDG PET-CT) demonstrates robust performance for staging multiple myeloma (MM). The study appeared in the journal Annals of Hematology.

In this study, researchers compared the number of MM bone focal lesions (MM) detected by both 18F-FDG PET-CT and whole-body diffuse weighted magnetic resonance imaging (WB-DWI) in 30 patients with newly diagnosed MM. Subsequently, they assessed the diagnostic capability of 18F-FDG PET-CT for diffuse infiltration.

The researchers observed that 18F-FDG PET-CT and WB-DWI were both interpreted as positive in 28 patients with an agreement of 1.00 (95% confidence interval [CI], 0.77-1.00) between the two procedures. The average focal bone lesions (FLs) detected by 18F-FDG PET-CT were 16.7, while WB-DWI detected an average of 23.9 FLs. The researchers observed that WB-DWI detected more FLs in the skull (P=0.001) and spine (P=0.006). 18F-FDG PET-CT showed moderate detection capacity (95% CI, 0.40-0.60) for the spine, sternum-ribs, and upper limbs, as well as substantial detection (95% CI, 0.60-0.80) for the pelvis and lower limbs. The researchers noted that regarding the diagnosis of diffuse bone marrow infiltration, the sensitivity, specificity, and accuracy of 18F-FDG PET-CT were 0.75, 0.79 and 0.77, respectively.

“Although WB-DWI detected more FLs than did 18F-FDG PET-CT, there was no difference in the detection of bone disease on a per-patient basis. 18F-FDG PET-CT showed high performance, including for evaluation of diffuse infiltration,” the researchers concluded.