Whole-Body MRI Is an Effective Imaging Modality for Hematological Malignancy Treatment Response Assessment: A Systematic Review and Meta-Analysis

Abstract

ObjectivesTo evaluate the diagnostic accuracy of whole-body MRI (WB-MRI) for assessment of hematological malignancies’ therapeutic response.MethodsPubMed, Embase, and Web of Science were searched up to August 2021 to identify studies reporting the diagnostic performance of WB-MRI for the assessment of hematological malignancies’ treatment response. A bivariate random-effects model was applied for the generation of the pooled diagnostic performance.ResultsFourteen studies with 457 patients with lymphoma, multiple myeloma, and sarcoma (very small proportion) were analyzed. Overall pooled sensitivity and specificity of WB-MRI were 0.88 (95% CI: 0.73–0.95) and 0.86 (95% CI: 0.73–0.93), respectively. Studies using whole-body diffusion-weighted imaging (WB-DWI) showed higher sensitivity than those that did not (0.94 vs. 0.55, p = 0.02). The pooled concordance rate of WB-MRI to assess hematological malignancies’ treatment response with reference standard was 0.78 (95% CI: 0.59–0.96). WB-MRI and PET/CT showed similar diagnostic performance (sensitivity [0.83 vs. 0.92, p = 0.11] and specificity [0.87 vs. 0.76, p = 0.73]).ConclusionWB-MRI has high diagnostic performance for hematological malignancies’ treatment response assessment. The adding of WB-DWI is strongly associated with increased sensitivity.

Imaging evaluation of lymphoma in pregnancy with review of clinical assessment and treatment options

“…Studies have also found that PET-CT is less accurate than WB-MRI in the diagnosis of indolent NHL due to the lack of FDG avidity in those patients. Lin G et al conducted a systematic review in 457 patients with either lymphoma, multiple myeloma, or sarcoma, and compared PET-CT to WB-MRI with diffusion-weighted imaging and WB-MRI without DWI [ 33 ]. They found that WB-MRI with diffusion-weighted imaging had a sensitivity of 94% for the detection of the aforementioned diseases, which was statistically significantly higher than the 88% sensitivity of WB-MRI without DWI [ 33 ].…”

“…Lin G et al conducted a systematic review in 457 patients with either lymphoma, multiple myeloma, or sarcoma, and compared PET-CT to WB-MRI with diffusion-weighted imaging and WB-MRI without DWI [33]. They found that WB-MRI with diffusion-weighted imaging had a sensitivity of 94% for the detection of the aforementioned diseases, which was statistically significantly higher than the 88% sensitivity of WB-MRI without DWI [33]. The primary conclusion of the study was that "WB-MRI All," which combined all sequences, had the highest sensitivity and specificity for the assessment of lymphoma when comparing to PET-CT, by 100% [34].…”

The Diagnostic Efficiency of Quantitative Diffusion Weighted Imaging in Differentiating Medulloblastoma from Posterior Fossa Tumors: A Systematic Review and Meta-Analysis

“…Malignant lesions usually have a smaller ADC value than benign lesions as a result of the narrow cytoplasm of tumor cells and the limited diffusion of water molecules [ 11 ]. At present, DWI has been applied for cancer diagnosis [ 12 ], tumor grading [ 13 ], and treatment response assessment [ 14 ]. Unfortunately, there is a large overlap in ADC values between different grades and types of tumors, making it unreliable to diagnose individual brain tumors using DWI alone [ 15 , 16 , 17 ].…”