Whole-Body MRI vs. PET/CT for the Detection of Bone Metastases in Patients With Prostate Cancer: A Systematic Review and Meta-Analysis

Abstract

Purpose: A recent meta-analysis in patients with non-small cell lung cancer showed no difference between whole-body magnetic resonance imaging (WBMRI) and positron emission tomography/computed tomography (PET/CT), but no such study is available for prostate cancer (PCa). This study aimed to compare WBMRI and PET/CT for bone metastasis detection in patients with PCa.Materials and Methods: PubMed, Embase, and the Cochrane library were searched for papers published up to April 2020. The population was the patients with untreated prostate cancer diagnosed by WBMRI or PET/CT. The outcomes were the true positive and negative and false positive and negative rates for WBMRI and PET/CT. The summarized sensitivity, specificity, positive likelihood ratios (PLR), negative likelihood ratios (NLR), and diagnostic odds ratios (DOR) were calculated with their 95% confidence intervals (CIs).Results: Four prospective and one retrospective study are included (657 patients). Significant differences are observed between WBMRI and PET/CT for sensitivity (WBMRI/PET/CT: 0.896; 95% CI: 0.813–0.987; P = 0.025) and NLR (WBMRI/PET/CT: 2.38; 95% CI: 1.13–5.01; P = 0.023), but not for specificity (WBMRI/PET/CT: 0.939; 95% CI: 0.855–1.031; P = 0.184) and PLR (WBMRI/PET/CT: 0.42; 95% CI: 0.08–2.22; P = 0.305). WBMRI has a similar a DOR compared with PET/CT (WBMRI/PET/CT: 0.13; 95% CI: 0.02–1.11; P = 0.062). The summary area under the receiver operating characteristic curves for WBMRI is 0.88 (standard error: 0.032) and 0.98 (standard error: 0.013) for PET/CT for diagnosing bone metastases in PCa.Conclusion: PET/CT presents a higher sensitivity and NLR for the bone metastasis detection from PCa, whereas no differences are found for specificity and PLR, compared with WBMRI.

Comparison of 68Ga-Prostate Specific Membrane Antigen (PSMA) Positron Emission Tomography Computed Tomography (PET-CT) and Whole-Body Magnetic Resonance Imaging (WB-MRI) with Diffusion Sequences (DWI) in the Staging of Advanced Prostate Cancer

“…Our study thus confirms the high diagnostic performance of WB-MRI for bone lesions detection that was primarily demonstrated in comparison with conventional techniques [ 22 , 29 , 30 , 31 ]. This study, however, suggests that PSMA PET-CT reaches similar diagnostic accuracy for bone metastasis detection, in line with published comparisons between MRI and PET/CT using either choline or PSMA ligands [ 32 , 33 ].…”

Hybrid Ga-68 prostate-specific membrane antigen PET/MRI in the detection of skeletal metastasis in patients with newly diagnosed prostate cancer: Contribution of each part to the diagnostic performance

“…There are studies showing that whole-body MRI has high sensitivity (80–94%) and specificity (83–94%) in demonstrating bone metastases in PCa patients [5,9,23,24]. In our study, the sensitivity was slightly lower than the previous studies (75%), while the specificity was observed at similar levels (96%).…”

The Role of Whole-Body Magnetic Resonance Imaging in Assessing Extrapulmonary Metastases in Osteosarcoma Staging and Restaging: A Pilot Study

“…The benefits of whole-body MRI in assessing skeletal metastases in various cancer types are well documented, with most reports suggesting the superiority of whole-body MRI over bone scintigraphy, whereas whole-body MRI and 18 F-FDG PET-CT showed a comparable diagnostic performance. [23][24][25][26][27][28] However, a few studies mainly investigated the benefits of whole-body MRI in identifying metastases in bone sarcomas. For example, in their subset of patients with Ewing sarcoma (n = 20) and osteosarcoma (n = 3), Daldrup-Link et al 29 documented that whole-body MRI had a sensitivity of 80% in identifying skeletal metastases, which was on par with 99mTc-MDP bone scintigraphy but lower than PET.…”

“…The benefits of whole-body MRI in assessing skeletal metastases in various cancer types are well documented, with most reports suggesting the superiority of whole-body MRI over bone scintigraphy, whereas whole-body MRI and 18 F-FDG PET-CT showed a comparable diagnostic performance 23–28 . However, a few studies mainly investigated the benefits of whole-body MRI in identifying metastases in bone sarcomas.…”